Korean J Hepatobiliary Pancreat Surg.  2002 Jun;6(1):20-25.

Effect on Regenerating Capacity of Transplanted Liver by Arterialized Native Liver in Auxiliary Heterotopic Liver Transplantation in Pig

• Lee HJ
• Roh HR
• Suh KS
• Lee KU

Abstract

BACKGROUND/AIMS: Auxiliary liver transplantation means a procedure in which part of the native liver is left in situ. In this method, it has been suggested that blocking of portal flow to the native liver (arterialized liver) could potentiate the regeneration of the graft liver. In this study, we evaluate the effect on regeneration capacity of graft liver by blocking the portal flow to the native liver in auxiliary heterotopic liver transplantation in pig.
METHODS
Female pigs weighing 25 kg and 30 kg were used as the donor and the recipient for liver transplantation, respectively. After total hepatectomy in the donor pig, graft liver was placed inferior to right liver and superior to right kidney of the recipient. The donor's hepatic vein was anastomosed to infrahepatic inferior vena cava superior to renal vein. The portal vein of the recipient was divided at the hilum and anastomosed with donor's portal vein. The donor's hepatic artery was anastomosed to the aorta below the renal artery. After 1, 3, 5, 7, 15th postoperative days, the weights of native and graft liver, proliferative cell nuclear antigen (PCNA) indices of both livers, and liver function test were checked.
RESULTS
During the procedure, hemodynamic status was stable without using venovenous bypass. There was no postoperative death and no severe deterioration of hepatic function. During 5th and 15th postoperative days, PCNA indices of graft liver (40~60%) were higher than those of native liver (30%). The weight of graft liver was increased more than 80% of preoperative value on day 7 and 15.
CONCLUSION
By arterialization of the native liver, the regeneration of the small graft liver could be accomplished smoothly without metabolic burden. This animal model is useful for studying graft liver physiology of liver transplantation in preclinical setting. With this study, the first case of auxiliary partial orthotopic liver transplantation was performed successfully in the patients who suffered from metabolic liver disease.

Keyword

Auxiliary heterotopic liver transplantation; Graft liver; Liver regeneration; Pig

MeSH Terms

Aorta
Female
Hemodynamics
Hepatectomy
Hepatic Artery
Hepatic Veins
Humans
Kidney
Liver Diseases
Liver Function Tests
Liver Regeneration
Liver Transplantation*
Liver*
Models, Animal
Physiology
Portal Vein
Proliferating Cell Nuclear Antigen
Regeneration
Renal Artery
Renal Veins
Swine
Tissue Donors
Transplants
Vena Cava, Inferior
Weights and Measures
Proliferating Cell Nuclear Antigen