Effects of Re-Arterialization on Early Graft Function and Regeneration in the Rat Model of Heterotopic Auxiliary Liver Transplantation

Abstract

In the rat model of heterotopic auxiliary liver transplantation, graft re-arterialization may influence the outcome of inter-liver competition. This was investigated in the current study using two transplanted groups with or without graft re-arterialization. Immediately after reperfusion, the re-arterialized grafts showed significantly higher bile flow rate and bilirubin excretion than the grafts without re-arterialization. DNA synthesis rate was also increased more drastically in the re-arterialized group following the transplantation. Without re-arterialization, the rats developed more pronounced cytolysis and cholestasis. Among the long-term survivors, all healthy re-arterialized grafts regenerated, whereas 5/6 non-re-arterialized grafts atrophied. These data demonstrate that the re-arterialization increases graft survival by improving early hepatic function, enhancing regenerative response and preventing post-transplant biliary complications in this rat model.

Introduction of a new method of rat liver transplantation using retrograde reperfusion

“…Some studies could show that a good outcome can be realized even without re-arterialisazion [2,9]. However, today there is an agreement that the rearterialisazion brings a profit to the graft liver [10].…”

“…Since then a lot of different methods for rat liver transplantation were published in which the focus mostly lies in the reduction of the anhepatic time and the way how to perform the vessel anastomoses [2][3][4][5][6][7][8][9][10][11][12][13].…”

A Novel Auxiliary Partial Orthotopic Liver Transplantation Model in Rats

“…HALT procedures have been used as standard models in the field of experimental rat auxiliary liver transplantation, and improved HALT models have recently been reported and applied for innovative research [10,11]. However, those models cannot be applied for research on APOLT, which is different from HALT; that is because the superior outcome of APOLT is attributed to its orthotopic graft positioning which enables better graft perfusion [2][3][4][5].…”

“…However, those models cannot be applied for research on APOLT, which is different from HALT; that is because the superior outcome of APOLT is attributed to its orthotopic graft positioning which enables better graft perfusion [2][3][4][5]. Portal perfusion of both the graft and the native liver was not realized in those previous HALT models either [10,11]. An early rat model of APOLT was reported by Nishio et al [6], in which the donor CLs and RLs were transplanted in a reversed fashion to a recipient after resection of the ML and LL of the native liver.…”

“…Post et al [15] reported that declamping of the hepatic artery of the grafted livers after portal reperfusion increased the LTBF by 23%. Fana et al [11] recently reported that rearterialization of the graft affects interliver functional competition. Although technically challenging, arterial reconstruction in our APOLT model would elucidate the arterial contribution of LTBF in APOLT grafts.…”