Effects of Re-Arterialization on Early Graft Function and Regeneration in the Rat Model of Heterotopic Auxiliary Liver Transplantation

Division of Experimental Surgery, Department of Surgery, University Hospital of Ghent, Belgium.
European Surgical Research (Impact Factor: 2.47). 02/2000; 32(1):11-7. DOI: 10.1159/000008735
Source: PubMed


In the rat model of heterotopic auxiliary liver transplantation, graft re-arterialization may influence the outcome of inter-liver competition. This was investigated in the current study using two transplanted groups with or without graft re-arterialization. Immediately after reperfusion, the re-arterialized grafts showed significantly higher bile flow rate and bilirubin excretion than the grafts without re-arterialization. DNA synthesis rate was also increased more drastically in the re-arterialized group following the transplantation. Without re-arterialization, the rats developed more pronounced cytolysis and cholestasis. Among the long-term survivors, all healthy re-arterialized grafts regenerated, whereas 5/6 non-re-arterialized grafts atrophied. These data demonstrate that the re-arterialization increases graft survival by improving early hepatic function, enhancing regenerative response and preventing post-transplant biliary complications in this rat model.

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    ABSTRACT: BACKGROUND: Rat liver transplantation is a common method in liver transplantation research. There are lots of different methods described until today. Although liver transplantation with retrograde reperfusion is established in the clinical routine there is no rat liver model described. METHODS: Arterialized rat liver transplantation with initial retrograde reperfusion was performed on n = 7 male LEWIS-(RT1)-rats. 1, 24 and 48 hours after the operation, serum parameters were determined. Furthermore, after 48 hours the liver was taken for histological assessment. RESULTS: The AST and the ALT levels showed a linear decrease during the first 48 hours after transplantation. GLDH levels showed an increase during the first 24 hours before they decreased strongly. In histology, the livers showed a good quality with only less necrosis. The highest amount of necrosis could be seen in the Rappaport zone 3. CONCLUSIONS: We were able to show that arterialized rat liver transplantation with initial retrograde reperfusion is feasible and shows a good outcome. Especially in centers where retrograde reperfusion of the liver is performed in clinical transplantation this method should be used for transplantation research to reach the closest possible relation between science and clinic.
    European Surgery 06/2012; 44(3). DOI:10.1007/s10353-011-0061-8 · 0.27 Impact Factor
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    ABSTRACT: Although auxiliary partial orthotopic liver transplantation (APOLT) has become a well-accepted procedure recently, a practical experiment model in APOLT using small animals has yet to be developed. Male Lewis rats were used for both donors and recipients. An auxiliary partial graft was obtained by ex vivo resection of the donor right and caudate lobes, and was transplanted orthotopically into the recipient after resection of the recipient medial and left hepatic lobes. Portal vein and hepatic duct reconstructions were by the cuff technique, and supra- and intrahepatic vena cava were sutured continuously. Operative outcomes, serum chemistry, liver tissue blood flow, angiographic and histopathological findings were then examined. Conventional orthotopic liver transplantation (OLT) procedures were also undertaken as a control. One-day, 1-week and 1-month survival rate of APOLT group was 100, 85 and 85%, respectively. AST in the APOLT group on the 1st postoperative day was significantly higher than in the OLT group. No significant differences were recognized in serum albumin and total bilirubin levels between the two groups. Although the portogram of an APOLT rat showed slight narrowing at the cuff anastomosis site, both the graft and the native liver were opacified similarly. The liver tissue blood flow on the 5th postoperative day in the native liver and the graft returned to as high as 95 and 74% of the values on laparotomy, respectively. Histological examinations of the auxiliary graft 1 month after transplantation showed mild ductular proliferation and mononuclear cell infiltration around the portal triads. This novel APOLT model in rats allows practical and reproducible results, and may be of value in the basic study of APOLT procedures.
    European Surgical Research 02/2000; 32(5):267-73. DOI:10.1159/000008774 · 2.47 Impact Factor
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    ABSTRACT: Auxiliary partial heterotopic liver transplantation (APHLT) with portal vein arterialization is a valuable procedure to be considered in the treatment of patients with acute liver failure and metabolic liver diseases. The aim of this study was to develop a new rat model of APHLT with liver dual arterial blood supply (LDABS). A total of 20 rats were used. The donor liver was resected, and the celiac trunk was reserved. Left and medial hepatic lobes accounting for 70% of the liver mass were removed en bloc and the suprahepatic caval vein was ligated simultaneously. Thus, 30% of the donor liver was obtained as the graft. Sleeve anastomosis of the graft portal vein and splenic artery were performed after narrowing the portal vein lumen through suturing. The right kidney of the recipient was removed, and sleeve anastomosis was performed between the celiac trunk of the graft and the right renal artery of the recipient. In addition, end-to-end anastomosis was performed between the infrahepatic caval vein of the graft and the right renal vein of the recipient. Following the reperfusion of the graft, the blood flow of the arterialized portal vein was controlled within the physiological range through suturing and narrowing under monitoring with an ultrasonic flowmeter. The bile duct of the graft was implanted into the duodenum of the recipient through an internal stent catheter. A 70% section of the native liver (left and medial hepatic lobes) was resected using bloodless hepatectomy. The mean operative duration was 154.5±16.4 min, and the warm and cold ischemia times of the graft were 8.1±1.1 min and 64.5±6.6 min, respectively. The blood flow of the arterialized portal vein to the graft was 1.8±0.3 ml/min/g liver weight. The success rate of model establishment (waking with post-surgical survival of >24 h) was 70% (7/10). Following successful model establishment, all rats survived 7 days post-surgery (100%; 7/7). The graft was found to be soft in texture and bright red in color following exploratory laparotomy. In conclusion, a new rat model of APHLT with LDABS without stent for vascular reconstruction was developed. This is a feasible and reliable rat model for liver transplantation study.
    Experimental and therapeutic medicine 02/2015; 9(2):367-371. DOI:10.3892/etm.2014.2110 · 1.27 Impact Factor