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A partial orthotopic liver transplantation technique (70% POLT) for use in rats and comparable with the corresponding recipient operation in the ‘splitting transplantation’ in man was developed. Body weight, liver function, histological and electron-microscopic findings were studied in comparison with whole rat liver transplantation with rearterialization, 30% POLT and corresponding liver resections. After 70 and 30% POLT typical signs of hepatic regeneration were found, but no pathological alterations in the electron-microscopic picture. This POLT model might be helpful for the investigation of unresolved questions in ‘splitting transplantation’.

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Ischemic injury to the liver is known to influence the outcome of liver transplantation. In this study the efficacy of Euro-Collins (EC), histidine-tryptophan-ketoglutarate (HTK), and University of Wisconsin (UW) preservation solution was analyzed in the model of orthotopic liver transplantation in syngeneic rats. The study design was as follows: Group I, Euro-Collins solution (n = 11); Group II, Histidine-Tryptophan-Ketoglutarate solution (n = 11); Group III, University of Wisconsin solution (n = 11). The rat liver transplantation was performed with arterialization of the graft as described by Engemann. The postoperative follow-up was 28 days. The perfusion flow rate of the preservation solution measured during organ perfusion revealed lowest levels in the UW group and comparable levels in Groups I and II. Postoperative graft function was monitored by measuring liver enzymes (aspartate amino-transferase, ASAT, alanine aminotransferase, ALAT), bilirubin and bile production. The survival rate was 10/11 in each group. Liver enzymes and bilirubin increased postoperatively and went back to normal within 2 or 3 weeks. In contrast to bilirubin, the liver enzymes showed a biphasic increase with maxima on the 1st and 5th days (range: ALAT, 220-264 U/L; ASAT, 145-177 U/L). Bile production was observed in all groups, but was significantly higher after UW-preservation (P < .005). Analysis of inflammatory cells revealed high concentrations of intrasinusoidal leukocytes and lymphocytes in the graft with a maximum on the 5th day.

The aim of the present study is to investigate the impact of bile duct reconstruction by a splint technique, a method which has not been sufficiently researched in animals after liver transplantation. Three experimental groups were set up: I = control, sham operation; II = bile duct reconstruction; III = orthotopic rat liver transplantation (ORLT). After bile duct reconstruction, serum levels of ASAT and ALAT in group II revealed a peak on the first postoperative day. The transplanted animals (group III) showed a second peak in liver enzyme levels on the fifth postoperative day; it was significantly higher than in group II. Serum bilirubin was more elevated in the transplant group, with a peak on day 7. Morphological investigations at the end of surgery revealed only intralobular necrosis and reactive changes in the liver capsule (group II); after transplantation (group III), there was also interstitial and intracellular edema, fatty degeneration and disintegration of the sinusoidal lining. One month later, necrosis, bile duct proliferation, cholestasis, cholangitis and vascular alterations were found in groups II and III. Furthermore, an increased rate of hepatocellular and bile duct proliferation was observed. These findings are partly due to the bile duct reconstruction. We recommend that a bile duct reconstruction control group should be included in ORLT experiments.

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Retrospective evaluation of 510 percutaneous CT-guided biopsies of the liver mainly fine-needle aspiration biopsies for cytology (89% of cases), yielded an overall accuracy rate of 92% and a sensitivity of 94%. The relatively high percentage of false-positive diagnoses (7% of all benign tumors) may be reduced by more consistent consideration of possible errors in cytology and a more consistent use of large bore biopsies.

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