A Novel Auxiliary Partial Orthotopic Liver Transplantation Model in Rats

Abstract

Background: 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. Methods: 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. Results: 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. Conclusion: This novel APOLT model in rats allows practical and reproducible results, and may be of value in the basic study of APOLT procedures.

Auxiliary Liver Transplantation for Cirrhosis: From APOLT to RAPID

“…Supplementary Digital Content Table 1, http://links.lww.com/SLA/D557 summarizes the 9 reported cases (1999–2021) 7–9,33–37 of 2-stage LT for ESLD. These cases were from Japan, France, Germany and Turkey.…”

“…These cases were from Japan, France, Germany and Turkey. Ikegami et al first described 2-stage LT in a patient with cirrhosis in 1999 34 . Balci et al reported the first 2 cases of RAPID 7,8 in 2020.…”

“…Only 1 patient had hepatocellular carcinoma 7 . Two-stage LT and RAPID were performed using liver grafts obtained from living donors in 8 cases 7–9,33–36 and deceased donors in 1 patient 37 . Among the 8 patients who underwent 2-stage LT and RAPID using living donors, only 2 had laparoscopically harvested grafts 9 …”

“…For the living donors, left-sided grafts (G23, 9 G234, G234-MHV, G1234 or G234’ 7,8,33–36 ) were transplanted in the recipients after H23, 8,9,33 H234, 34,35 H231’4’-MHV or H234-MHV 7,36 …”

Auxiliary partial orthotopic liver transplantation: treatment of acute liver failure in a new rat model

“…Graft rearterialization and internal biliary drainage did not occur. Ikegami et al used the right and left liver lobes as auxiliary grafts, which were orthotopically implanted under total vascular exclusion into the recipient without graft rearterialization [20]. In both models, the clinical situation after APOLT, in particular the interaction between the regenerating native and the transplanted liver, was incompletely simulated since no true localization of the auxiliary graft is realized in these models.…”