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Development of a New Technique for Reconstruction of Hepatic Artery during Liver Transplantation in Sprague-Dawley Rat.

Liu X, He C, Huang T, Gu J - PLoS ONE (2015)

Bottom Line: During transplantation, the anhepatic phase lasted 18 ± 2.5 min and the artery reconstruction only required ~3 minutes.The patency rate was 94.44% and the 4-week survival rate was 90%.Histology indicated obvious fibrosis in the liver grafts without artery reconstruction, while normal histology was observed in the arterialized graft.

View Article: PubMed Central - PubMed

Affiliation: Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Department of pathology; Collaborative and Creative Center, and Center of Translation Medicine, Shantou University Medical College, Shantou, Guangdong, China.

ABSTRACT

Background: Sleeve anastomosis is the most common technique used to rearterialize orthotopic liver transplants (OLT). However, this technique has a number of disadvantages, including difficulty of performance of the technique visually unaided. We herein describe a novel rearterialized OLT model in the rat.

Materials and methods: Forty-six male Sprague Dawley rats (300-400 g) were used as donors and recipients. Based on Kamada's cuff technique, the new model involved performing a modified "sleeve" anastomosis between the celiac trunk of the donor and common hepatic artery of the recipient to reconstruct blood flow to the hepatic artery. An additional ten male Sprague Dawley rats underwent liver transplantation without artery reconstruction. Liver grafts were retrieved from the two groups and histological examination was performed following surgery.

Results: Total mean operating times were ~42 minutes for the donor liver extraction and 57 minutes for the recipient transplantation. Graft preparation took an additional 15 minutes and the time to fix the arterial bracket was ~3 minutes. During transplantation, the anhepatic phase lasted 18 ± 2.5 min and the artery reconstruction only required ~3 minutes. The patency rate was 94.44% and the 4-week survival rate was 90%. Histology indicated obvious fibrosis in the liver grafts without artery reconstruction, while normal histology was observed in the arterialized graft.

Conclusions: This new method allows for the surgical procedure to be performed visually unaided with good survival and patency rates and represents an alternative model investigating OLT in rats.

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Illustrations of potential accidents during the placement of the guiding stitches.
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pone.0145662.g006: Illustrations of potential accidents during the placement of the guiding stitches.

Mentions: As illustrated in Fig 6, there may be an increased incidence of surgical errors when the surgeon is initially learning the technique for the placement of the guiding stitches in small diameter vessels. These issues concerning the accurate placement of the first suture were worked out by trial and error prior to the start of our study. We found that the use of a bracket inserted into the celiac axis, reduced and in most cases eliminated surgical errors during the placement of the guiding stiches.


Development of a New Technique for Reconstruction of Hepatic Artery during Liver Transplantation in Sprague-Dawley Rat.

Liu X, He C, Huang T, Gu J - PLoS ONE (2015)

Illustrations of potential accidents during the placement of the guiding stitches.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4696743&req=5

pone.0145662.g006: Illustrations of potential accidents during the placement of the guiding stitches.
Mentions: As illustrated in Fig 6, there may be an increased incidence of surgical errors when the surgeon is initially learning the technique for the placement of the guiding stitches in small diameter vessels. These issues concerning the accurate placement of the first suture were worked out by trial and error prior to the start of our study. We found that the use of a bracket inserted into the celiac axis, reduced and in most cases eliminated surgical errors during the placement of the guiding stiches.

Bottom Line: During transplantation, the anhepatic phase lasted 18 ± 2.5 min and the artery reconstruction only required ~3 minutes.The patency rate was 94.44% and the 4-week survival rate was 90%.Histology indicated obvious fibrosis in the liver grafts without artery reconstruction, while normal histology was observed in the arterialized graft.

View Article: PubMed Central - PubMed

Affiliation: Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Department of pathology; Collaborative and Creative Center, and Center of Translation Medicine, Shantou University Medical College, Shantou, Guangdong, China.

ABSTRACT

Background: Sleeve anastomosis is the most common technique used to rearterialize orthotopic liver transplants (OLT). However, this technique has a number of disadvantages, including difficulty of performance of the technique visually unaided. We herein describe a novel rearterialized OLT model in the rat.

Materials and methods: Forty-six male Sprague Dawley rats (300-400 g) were used as donors and recipients. Based on Kamada's cuff technique, the new model involved performing a modified "sleeve" anastomosis between the celiac trunk of the donor and common hepatic artery of the recipient to reconstruct blood flow to the hepatic artery. An additional ten male Sprague Dawley rats underwent liver transplantation without artery reconstruction. Liver grafts were retrieved from the two groups and histological examination was performed following surgery.

Results: Total mean operating times were ~42 minutes for the donor liver extraction and 57 minutes for the recipient transplantation. Graft preparation took an additional 15 minutes and the time to fix the arterial bracket was ~3 minutes. During transplantation, the anhepatic phase lasted 18 ± 2.5 min and the artery reconstruction only required ~3 minutes. The patency rate was 94.44% and the 4-week survival rate was 90%. Histology indicated obvious fibrosis in the liver grafts without artery reconstruction, while normal histology was observed in the arterialized graft.

Conclusions: This new method allows for the surgical procedure to be performed visually unaided with good survival and patency rates and represents an alternative model investigating OLT in rats.

Show MeSH
Related in: MedlinePlus