BACKGROUNDCryopreserved conduit valved homografts (CVH) have been widely used in surgical treatment of cardiac disease. This study aimed to determine the extent of host cell ingrowth and the durability and immunogenicity of CVH, and to compare the performance of CVH stored at 4°C and CVH cryopreserved in liquid nitrogen at -196°C.

METHODSHeterotopic transplants of canine CVH stored at 4°C (n = 14) and cryopreserved in liquid nitrogen (n = 14) were made onto the abdominal aorta of recipient dogs. Animals were sacrificed at 7 and 15 days and at 1, 3, 6, 9, and 12 months after transplantation to excise the implanted CVHs. Tissue DNA extraction and quantitative polymerase chain reaction (PCR) were performed to calculate the ratio of donor cells and host cells in the CVH. The tissue viability of CVH after implantation was analyzed by detecting alkaline fibroblast growth factor 2 (FGF-2) using immunohistochemical staining and by observation under transmission electron microscope and scanning electron microscope.

RESULTSAll the animals survived and recovered well. There were few repopulating host cells (0.04% - 0.83%) in the implanted CVH at 7 or 15 days. The ratio of ingrowing host cells into the CVH continued rising after implantation and reached 40% - 47% in the 12th month postoperation. Histology, transmission electron microscopy and FGF-2 immunohistochemical staining indicated that fibroblasts and the host's endothelial cells were the main cellular elements invading the CVH. There were no significant differences in results between CVH stored at 4°C and CVH cryopreserved in liquid nitrogen.

CONCLUSIONSHost cells growing into CVH are very important for maintaining the long-term structure and function of the implanted CVH. There is no significant difference between CVH storing at 4°C or in liquid nitrogen in regard to the ingrowth of host cells or of morphologic features after CVH allografting.

Animals ; Aorta ; transplantation ; ultrastructure ; Dogs ; Immunohistochemistry ; Microscopy, Electron, Transmission ; Polymerase Chain Reaction ; Pulmonary Artery ; transplantation ; ultrastructure ; Transplantation, Homologous ; methods

BACKGROUND: Chronic rejection after a cardiac allograft usually occurs about six months after the operation. Vasculopathy due to chronic rejection causes atherosclerosis in the coronary artery of the transplanted heart and then this causes myocardial injury. We intended to discover and document those findings that occur in a transplanted ascending aorta. MATERIAL AND METHOD: In rats weighting 200~300 gm (Spraque-Dawley rat), we carried out heterotopic heart allo-transplantation with the modified Ono-Lindsey method and then the rats were administrated cyclosporine (10 mg/kg/day). After three months survival, we acquired biopsy materials from the native ascending aorta and the allo-transplanted ascending aorta and we compared them. We classified each severity of 1) intimal thickening, 2) medial hyperplasia, 3) medial calcification, 4) medial inflammation and 5) chondroid metaplasia, which are specific biopsy findings for chronic rejection after a cardiac allograft. Each severity was classified, according to the opinion of one pathologist, in the native ascending aorta biopsies (n=9) and the allo-transplanted ascending aorta biopsies (n=13). The data of the control group and the study group were statistically analyzed with using the Mann-Whitney test (SPSS version 12.0 window). RESULT: The important changes of the allo-transplanted aorta were intimal thickening (p<0.0001), medial calcification (p=0.045), medial inflammation (p<0.0001) and chondroid metaplasia (p=0.045), but not medial hyperplasia (p=0.36). CONCLUSION: Cardiac allograft vasculopathy was seen in the transplanted ascending aorta, the same as was seen in the coronary artery, after allograft cardiac transplantation. We have reached the conclusion that chronic rejection also progresses in the aorta.
Animals ; Aorta ; Atherosclerosis ; Biopsy ; Coronary Vessels ; Cyclosporine ; Heart ; Heart Transplantation ; Hyperplasia ; Inflammation ; Metaplasia ; Rats ; Rejection (Psychology) ; Transplantation, Homologous ; Transplants

Transplant arteriosclerosis is the main limitation for long-term survival of solid organ transplant recipients. Animal models would provide invaluable tools to investigate the cellular and molecular mechanisms underlying the pathogenesis of transplant arteriosclerosis, as well as for studies with novel drugs and other reagents for the prevention of the disease. We have therefore developed a modified technique for aortic transplantation in mice. The central suture ligation of the recipient abdominal aorta allowed a simpler end-to-side anastomosis of a segment of the donor thoracic aorta into the infrarenal portion of the recipient abdominal aorta. Using this technique, the overall survival rate was 94%. We also observed typical aspects of chronic rejection of the aortic allografts not observed with isografts. Our new technique is relatively easy to perform and has a low incidence of thrombosis, thus being useful for studying various aspects of transplant arteriosclerosis.
*Transplantation, Heterotopic ; Reverse Transcriptase Polymerase Chain Reaction ; Mice, Inbred C57BL ; Mice, Inbred BALB C ; Mice ; Male ; Aorta/*transplantation ; Animals

With increasing demand for liver transplantation, liver grafts are used from marginal donors who were not considered suitable. This trend toward the use of marginal donors reinforces the need to balance the recipient's condition and graft quality and to perform a liver retrieval process with a proper method for preservation of liver function. Although the issues in organ procurement are debatable, rapid and high pressure perfusion for the aorta only with a cold dissection method can be an optimal method for the successful recipient outcome in liver transplantation using a marginal graft.
Aorta ; Humans ; Liver Transplantation ; Liver* ; Perfusion ; Tissue and Organ Procurement ; Tissue Donors ; Transplants

Although the standard treatment of abdominal aortic aneurysm has shifted from open surgery to endovascular repair, open surgery has remained the standard of care for complex aneurysms involving the visceral arteries and in patients unsuitable for endovascular aneurysm repair. Postoperative renal insufficiency may occur after open surgical repair of suprarenal abdominal aortic aneurysm. Methods of minimizing renal ischemic injury include aortic cross-clamping and renal reconstruction techniques. This report describes the use of renal autotransplantation for renal reconstruction during open surgical repair of a suprarenal abdominal aortic aneurysm. This technique was successful, suggesting its feasibility for open suprarenal abdominal aortic aneurysm repair, minimizing renal ischemic injury and optimizing postoperative renal function.
Aneurysm ; Aorta ; Aortic Aneurysm, Abdominal* ; Arteries ; Autografts* ; Humans ; Kidney ; Renal Insufficiency ; Standard of Care ; Transplantation

The renal arteriographies in 205 living renal transplant donors (male 118, female 87) were reviewed retrospectively to evaluate the anatomical variations of the renal arterial system in Korean adults. The mean length of the right renal arteries in male and female was longer than that of the left renal arteries (P<0.05). The mean diameter of the renal arteries in male (8.14+/-0.94cm) was longer than that of female (7.29+/-0.93cm) (p<0.05). But the mean ratio of the diameter of the renal artery to aorta between male and female was not significantly different (male 42.1+/-5.8%, female 41.2+/-6.2%). Polar arteries originating from the aorta were identified in 54 cases (26.3%; male 31.3%, female 19.5%). The frequency of the polar arteries on the left kidney was higher than that of the right kidney (19.5% vs 10.7%, p<0.05) and 8 cases (3.9%) had bilateral polar arteries. The supplementary arteries which arises in the proximal portion of main renal artery were identified in 58 cases (28.3%). The frequency of the supplementary arteries on the right kidney (40 cases, 19.5%) was higher than that of the left kidney (26 cases, 12.7%) (p<0.05) and 8 cases (3.9%) had bilateral supplementary arteries. The distribution area of polar artery (29.1+/-13.8%) was larger than that of supplementary arteries (17.0+/-11.1%) (p<0.05). In conclusion, anatomical variations of the renal arterial system in Korean adults were similar to those of western and these data will be helpful to understand renal arterial system in Korean adults.
Adult* ; Angiography* ; Aorta ; Arteries ; Female ; Humans ; Kidney ; Kidney Transplantation ; Male ; Renal Artery ; Retrospective Studies ; Tissue Donors*

Stem cells transplantation is a promising strategy for treating myocardial infarction and/or chronic heart failure; however, with respect to nonischemic heart failure, there are some limitations inherent in the current methods of transplantation. In this study, we investigated the feasibility of a novel method, i. e. transplantation through the root of aorta when the ascending aorta occluded above the sinus aortae. Japanese white ears rabbits were used as chronic heart failure models by intravenous injection of adriamycin. Autologous bone marrow mononuclear cells (MNC) were infused into the root of aorta when the ascending aorta was occluded by a couple of balloons above the sinus aortae. After 4 weeks, ejection fraction was significantly improved in MNC group. In conclusion, we have developed a unique method for efficient and safe cell transplantation based on infusion in aorta. This method, potentially suitable for nonischemic heart failure and could be used to achieve even and global supply of cells in heart.
Animals ; Aorta ; surgery ; Doxorubicin ; Feasibility Studies ; Heart Failure ; chemically induced ; surgery ; Rabbits ; Stem Cell Transplantation ; methods

Celiac trunk is the artery of foregut, arising from the abdominal aorta at the level of T12/L1 vertebral body. It extends approximately 1.5 to 2 cm horizontally forwards before dividing into three branches: left gastric, common hepatic, and splenic arteries. Out of the three ventral branches of abdominal aorta, celiac trunk is more prone to have variations. During routine dissection of abdomen for undergraduate students we found some rare variations in the branching pattern of the celiac trunk. Absence of celiac trunk with hepatomesenteric trunk, quadrifurcation with dorsal pancreatic artery arising from it, quadrifurcation with middle colic artery arising from it, left inferior phrenic artery arising from celiac trunk, highly tortuous splenic artery supplying distal 1/3rd of transverse colon and hepatosplenic trunk. Knowledge of such variations is essential for liver and pancreas transplantations, pancreaticoduodenectomy, radiological abdominal interventions, laproscopic surgeries, and in trauma of the abdomen.
Abdomen ; Aorta, Abdominal ; Arteries ; Colic ; Colon, Transverse ; Humans ; Liver ; Pancreas Transplantation ; Pancreaticoduodenectomy ; Splenic Artery

In 1964, Abbott and Colleagues published the world's first heterotopic heart transplantation technique in the rat. Their method established circulation by end-to-end anastomoses of the graft's aorta and pulmonary artery to the recipient's abdominal aorta and Inferior Vena Cava (IVC), respectively. In 1966, Tomita et al altered Abbott's technique by employing end-to-side rather than end-to-end anastomoses, thus eliminating the hind leg paralysis that sometimes resulted from Abbott's technique. In order to prevent postsuture hemorrhage (since 7-0 silk suture was the finest available at that time), Tomita's aortic anastomosis was done with double up-and-down continuous suture technique. A single layer continuous anstomosis effected the pulmonary artery-IVC anastomosis. The availability of Nylon monofilament suture made it possible for Ono and Lindsey to use a single layer suture technique for the aortic end-to-side anastomosis in their modified rat heart transplantation. We observed survival time between control group and Immunosuppression (Cyclosporine administration, 10mg/Kgx4 times postoperatively) group after heterotopic heart transplantation in the rat model. The cyclosporine adminstration group survived longer than the control group, thus we concluded that cyclosporine was based on Immunosuppressive drugs.
Allografts ; Animals ; Aorta ; Aorta, Abdominal ; Cyclosporine ; Heart Transplantation* ; Heart* ; Hemorrhage ; Immunosuppression ; Leg ; Models, Animal* ; Nylons ; Paralysis ; Pulmonary Artery ; Rats* ; Silk ; Suture Techniques ; Sutures ; Vena Cava, Inferior

PURPOSE: In liver transplantation, low portal perfusion pressure may result in underperfusion of grafts and be the cause of primary nonfunction. Partial arterialization of portal vein could preserve graft perfusion. Up till now, there have been several clinical cases of temporary or permanent portal arterialization in liver transplantation. METHODS: In this study, we designed rat model for evaluating the effect of portal arterialization to improve survival of the under-perfused graft. Partial heterotopic non-regenerative liver transplantation was used with portal inflow only from inferior vena cava, which is known as portal under-perfusing liver transplantation model. Partial portal arterialization was performed by fenestration of the common wall between the IVC and the aorta through venotomy which was made for portacaval anastomosis. RESULTS: Immediate after arterialization, satisfactory macroscopic and duplex ultrasonographic liver perfusion were seen and the arterialized-graft survival was significantly improved to 95% (19/20) vs. 35% (7/20) of nonarterialized grafts. At 2-week after transplantation, the arterialized liver graft was atrophied showed normal gross appearance. The histopathologic examination with light microscope revealed no significant pathologic abnormality. CONCLUSION: Partial portal arteria;ization improved graft-survival of the under-perfusing liver grafts significantly and not affects the histologic hepatic structure adversely.
Aorta ; Graft Survival* ; Liver Transplantation* ; Liver* ; Models, Animal ; Perfusion ; Portacaval Shunt, Surgical ; Portal Vein ; Transplants* ; Vena Cava, Inferior