Auxiliary Liver Transplantation in the Rat, Influence of the Condition of the Recipient&amp;rsquo;s Liver on the Fate of the Graft

Hess, F.; Willemen, A.M.; Jerusalem, C

doi:10.1159/000127946

Cited by 19 publications

(15 citation statements)

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“…17 The portal vein of the graft was anastomosed with the portal vein of the recipient. During this procedure, the portal venous blood supply to the native liver is compromised.…”

Section: Representative Resultsmentioning

confidence: 99%

Heterotopic Auxiliary Rat Liver Transplantation With Flow-regulated Portal Vein Arterialization in Acute Hepatic Failure

Schleimer

Kalder

Grommes

et al. 2014

JoVE

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In acute hepatic failure auxiliary liver transplantation is an interesting alternative approach. The aim is to provide a temporary support until the failing native liver has regenerated.1-3 The APOLT-method, the orthotopic implantation of auxiliary segments-averts most of the technical problems. However this method necessitates extensive resections of both the native liver and the graft. A liver graft reduced to 30 % of its original size, was heterotopically implanted in the right renal region of the recipient after explantation of the right kidney. The infra-hepatic caval vein of the graft was anastomosed with the infrahepatic caval vein of the recipient. The arterialization of the donor's portal vein was carried out via the recipient's right renal artery with the stent technique. The blood-flow regulation of the arterialized portal vein was achieved with the use of a stent with an internal diameter of 0.3 mm. The celiac trunk of the graft was end-to-side anastomosed with the recipient's aorta and the bile duct was implanted into the duodenum. A subtotal resection of the native liver was performed to induce acute hepatic failure. 7In this manner 112 transplantations were performed. The perioperative survival rate was 90% and the 6-week survival rate was 80%. Six weeks after operation, the native liver regenerated, showing an increase in weight from 2.3±0.8 g to 9.8±1 g. At this time, the graft's weight decreased from 3.3±0.8 g to 2.3±0.8 g.We were able to obtain promising long-term results in terms of graft morphology and function. HALT with flow-regulated PVA reliably bridges acute hepatic failure until the native liver regenerates. Video LinkThe video component of this article can be found at

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“…17 The portal vein of the graft was anastomosed with the portal vein of the recipient. During this procedure, the portal venous blood supply to the native liver is compromised.…”

Section: Representative Resultsmentioning

confidence: 99%

Heterotopic Auxiliary Rat Liver Transplantation With Flow-regulated Portal Vein Arterialization in Acute Hepatic Failure

Schleimer

Kalder

Grommes

et al. 2014

JoVE

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“…Functional competition between the native liver and the graft has also been observed in APOLT [5,9,23]. Some investigators claim that hepatotrophic factors in portal blood are the essential cause of this functional competition [33][34][35], while others report that graft atrophy accompanying functional deterioration of the graft is directly related to the degree of functional impairment of the native liver [32,36]. Banding of the portal vein to the native liver was performed in order to keep up a sufficient portal blood flow to the graft and to prevent graft atrophy [5,[18][19][20][21]23].…”

Section: Discussionmentioning

confidence: 99%

Portal Blood Flow and Liver Regeneration in Auxiliary Partial Orthotopic Liver Transplantation in a Canine Model

et al. 1999

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Functional competition has been shown to lead to a detrimental outcome in auxiliary liver transplantation. We evaluated the interaction in auxiliary partial orthotopic liver transplantation between the native liver and the graft in terms of portal flow and regeneration. The need for diversion of the portal flow to the graft was also assessed. Reduced-size liver grafts were transplanted orthotopically after partial hepatectomy in beagles. There were two groups: the preserved group, where portal inflow to the native liver was preserved, and the ligated group, where it was interrupted. Portal flow was measured serially and liver regeneration was evaluated on postoperative day 5. Functional competition was not observed in the preserved group. On the other hand, ligation of the native liver portal vein had no obviously detrimental effects on the remnant native liver. This leads to the conclusion that the portal vein to the native liver can be safely ligated to prevent functional competition.

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“…However, little attention has been paid to a possible relation between the HPBF and the total liver flow [4,23]. The functional load is another parameter largely neglected in its significance for both the integrity and regenerative ability of the liver, although on this topic a large body of data has been obtained with the study of auxiliary liver transplantation [7,8,[10][11][12][13]. Finally, unspecific factors provoked by environmental influences, surgical trauma, and stress, respectively, have also been reported to interfere with the normal hepatic potentialities [2,18,25,27].…”

Section: Discussionmentioning

confidence: 99%

“…Recently, liver transplantation in the rat has proven to be a reliable model yielding reproducible results [7,8,10,14,15] provided particular physiologic requirements are met, such as a preferably negative venous outflow pressure for optimal perfusion [7,12]. After auxiliary liver transplantation, both healthy livers with normal functional capacity exert mutual influences [7,10,11].…”

Section: Introductionmentioning

confidence: 99%

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Survival of Auxiliary Rat Liver Grafts with Decreased Portal Blood Flow

Hess¹,

Willemen²,

Jerusalem³

1978

Eur Surg Res

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After auxiliary liver transplantation in the rat, partial liver grafts (30% of the liver) were perfused with mesentericosplenic venous blood. This means a decrease in the total liver blood flow by approximately 34%. Recipient livers retained their arterial and pancreaticoduodenal inflow. Surgical interventions were carried out on the recipient’s liver to evaluate the effect of the varying iriduced functional handicap on the fate of the graft in association with a decreased liver blood flow. Graft survival was obtained in all groups, but the conditions of the graft varied inversely with the severity of the functional handicap of the recipient’s liver. Compared to previous experiments in which the auxiliary grafts were supplied with total portal blood inflow in the same experimental model, the grafts in this study showed a slightly impaired increase in weight. This impairment was attributed to the decreased blood flow. Recipient livers deteriorated or just maintained their size, even after 70% hepatectomy, despite the pancreaticoduodenal venous and arterial inflow. These results suggest that the total liver blood flow in combination with the functional state of the remaining recipient liver, rather than the quality of venous blood deriving from certain splanchnic areas and/or peculiar factor convoyed with it, determines the survival of a liver graft.

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Auxiliary Liver Transplantation in the Rat, Influence of the Condition of the Recipient’s Liver on the Fate of the Graft

Cited by 19 publications

References 0 publications

Heterotopic Auxiliary Rat Liver Transplantation With Flow-regulated Portal Vein Arterialization in Acute Hepatic Failure

Heterotopic Auxiliary Rat Liver Transplantation With Flow-regulated Portal Vein Arterialization in Acute Hepatic Failure

Portal Blood Flow and Liver Regeneration in Auxiliary Partial Orthotopic Liver Transplantation in a Canine Model

Survival of Auxiliary Rat Liver Grafts with Decreased Portal Blood Flow

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