Skip to main content
SpringerLink
Log in

Technique for orthotopic reduced-size hepatic transplantation combined withex vivo liver cut down in the rat

  • Transplantation
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

A technique is described for orthotopic reduced-size hepatic transplantation combined withex vivo liver cut down in the rat. Following perfusion of the donor liver with cold heparinized saline, the portal veins, bile ducts, and hepatic arteries to the median and left lobes together were dissectedin situ, encircled, and divided. After harvesting the donor liver, a hepatectomy was performed byex vivo liver cut down of the median and left lobes. The remnant amounted to 32% of the whole liver. As a result, the suprahepatic vena cava could be well visualized with adequate exposure for vascular anastomosis. Orthotopic reduced-size hepatic transplantation was performed using the right and caudate lobes of the liver. The suprahepatic vena cava was anastomosed with a 7-0 silk running suture. A simplified cuff without processes was made with an obliquely cut polyethylene tube and used for the portal and infrahepatic caval anastomoses. A Teflon tube stent was used for the biliary anastomosis. The newly devised angled clamp and flexible arm were used for the cuff attachment and operative procedure. Transplant survival followingex vivo liver cut down was as good as that with whole liver transplantation. Reestablishment of the hepatic artery restores liver function following transplantation. The maximum hepatocyte labeling index (LI) occurs 24 hr after a 68% hepatectomy, and at 36 hr following a reduced-size hepatic transplantation with or without hepatic arterialization. Possible explanations for the slight delay in achieving the maximal LI may include damage that is induced by the operation itself, pregraft preservation, and reperfusion injuries. In conclusion, the anatomical features of the hepatic lobes in rats are well suited to successful completion ofex vivo liver cut down.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Broelsch CE, Emond JC, Thistlethwaite JR, Rouch DA, Whitingtington PF, Lichtor JL: Liver transplantation with reduced-size donor organs. Transplantation 45:519–524, 1988

    PubMed  Google Scholar 

  2. Broelsch CE, Whitington PF, Emond JC, Heffron TG, Thistlewaite JR, Stevens L, Piper J, Whitington SH, Lichtor JL: Liver transplantation in children from living related donors. Ann Surg 214:428–439, 1991

    PubMed  Google Scholar 

  3. Tanaka K, Uemoto S, Tokunaga Y, Fujita S, Sano K, Nishizawa T, Sawada H, Shirahase I, Kim HJ, Yamaoka Y, Ozawa K: Surgical techniques and innovations in living related liver transplantation. Ann Surg 217:82–91, 1993

    PubMed  Google Scholar 

  4. Rossi G, de Carlis L, Doglia M, Fassati LR, Tarenzi L, Galmarini D: Orthotopic transplantation of partially hepatectomized liver in the pig. Transplantation 43:362–365, 1987

    PubMed  Google Scholar 

  5. Kahn D, Makowka L, Lai H, Eagon PK, Dindzans V, Starzl TE, Van Thiel DH: Cyclosporine augments hepatic regenerative response in rats. Dig Dis Sci 35:392–398, 1990

    PubMed  Google Scholar 

  6. Francavilla A, Porter KA, Benichou J, Jones AF, Starzl TE: Liver regeneration in dogs: Morphological and chemical changes. J Surg Res 25:409–419, 1979

    Google Scholar 

  7. National Institutes of Health: Guide for the care and use of laboratory animals. Public Health Service, NIH, NIH publication No. 86-23, Bethesda, Maryland, 1985

  8. Zhao D, Zimmermann A, Wheatley AM: Morphometry of the liver allograft liver transplantation in the rat: significance of an intact arterial supply. Hepatology 17:310–317, 1993

    PubMed  Google Scholar 

  9. Szybalski W: Research in radiotherapy: Approaches to chemical sensitization.In Nuclear Science Service Report No. 35, Publication No. 888. RF Kallman (ed). National Academy of Science National Research Council, Washington, DC, 1961, p 162

    Google Scholar 

  10. Cawood AH, Savage JR: A comparison of the use of bromodeoxyuridine and [3H]thymidine in studies of the cell cycle. Cell Tissue Kinet 16:51–57, 1983

    PubMed  Google Scholar 

  11. Higgins GM, Anderson RM: Experimental pathology of the liver. I. Restoration of the liver of the white rat following partial surgical removal. Arch Pathol 12:186–188, 1931

    Google Scholar 

  12. Zimmerman FA, Butcher GW, Davies HS, Brons G, Kamada N, Turello O: Techniques for orthotopic liver transplantation in the immunologic response to fully allogeneic liver grafts. Transplant Proc 11:571–577, 1979

    PubMed  Google Scholar 

  13. Kamada N, Calne RY: Orthotopic liver transplantation in the rat: technique using cuff for portal vein anastomosis and biliary drainage. Transplantation 28:47–50, 1979

    PubMed  Google Scholar 

  14. Lee S, Charters AC, Chandler JG, Orloff MJ: A technique for orthotopic liver transplantation in the rat. Transplantation 16:664–669, 1973

    PubMed  Google Scholar 

  15. Miyata M, Fischer JH, Fuhs M, Isselhard W, Kasai Y: A simple method for orthotopic liver transplantation in the rat. Cuff technique for three vascular anastomoses. Transplantation 30:335–338, 1980

    PubMed  Google Scholar 

  16. Xia R, Emond JC: Orthotopic partial liver transplantation in the rat: A model of 70% hepatectomy and reduced size liver transplantation. Transplantation 56:1041–1043, 1993

    PubMed  Google Scholar 

  17. Rossi G, de Carlis L, Doglia M, Fassati LR, Tarenzi L, Galmarini D: Orthotopic transplantation of partially hepatectomized liver in the pig. Transplantation 43:362–365, 1987

    PubMed  Google Scholar 

  18. Parke WW, Michels NA, Ghosh GM: Blood supply of the common bile duct. Surg Gynecol Obstet 117:47–55, 1963

    PubMed  Google Scholar 

  19. Clark RA, Gallant TE: Bile duct strictures associated with hepatic arterial infusion chemotherapy. Gastrointest Radiol 12:148–151, 1987

    PubMed  Google Scholar 

  20. Mitra SK: The terminal distribution of the hepatic artery with special reference to arterio-portal anastomosis. J Anat 100:651–663, 1966

    PubMed  Google Scholar 

  21. Northover JMA, Williams EDF, Terblanche J: The investigation of small vessel anatomy by scanning electron microscopy of resin casts: A description of the technique and examples of its use in the study of the microvasculature of the peritoneum and bile duct wall. J Anat 130:43–54, 1980

    PubMed  Google Scholar 

  22. Kamada N, Sumimoto R, Kaneda K: The value of hepatic artery reconstruction as a technique in rat liver transplantation. Surgery 111:195–200, 1992

    PubMed  Google Scholar 

  23. Howden B, Jablonski P, Grossman H, Marshall VC: The importance of the hepatic artery in rat liver transplantation. Transplantation 47:428–431, 1989

    PubMed  Google Scholar 

  24. Zimmermann FA, Butcher GW, Davies HS, Brons G, Kamada N, Turel O: Techniques for orthotopic liver transplantation in the rat and some studies of the immunologic responses to fully allogeneic liver grafts. Transplant Proc 11:571–577, 1979

    PubMed  Google Scholar 

  25. Sumimoto R, Shinomiya T, Yamaguchi A: Influence of hepatic arterial blood flow in rats with liver transplants: Examination of donor liver-derived serum class I MHC antigen in rats with liver transplants with or without hepatic arterial reconstruction. Transplantation 51:1138–1139, 1991

    PubMed  Google Scholar 

  26. Howden B, Jablonski P, Grossman H, Marshall VC: The importance of the hepatic artery in rat liver transplantation. Transplantation 47:428–431, 1989

    PubMed  Google Scholar 

  27. Gassel HJ, Engemann R: Preservation of rat liver grafts. Transplantation 44:726–727, 1987 (letter)

    PubMed  Google Scholar 

  28. Hickman R, Engelbrecht GH, Duminy FJ: A technique for liver transplantation in the rat. Transplantation 48:1080, 1989 (letter)

    PubMed  Google Scholar 

  29. Kamada N, Sumimoto R, Kaneda K: The value of hepatic artery reconstruction as a technique in rat liver transplantation. Surgery 111:195–200, 1992

    PubMed  Google Scholar 

  30. Kazuhide Y, Igor S, Phillips MJ, Fisher MM: Three dimentional observation of the hepatic arterial termination in rat, hamster and human livers by scanning electron microscopy. Hepatology 5:452–456, 1986

    Google Scholar 

  31. Kassissia I, Brault A, Huet P-M: Hepatic artery and portal vein vascularization of normal and cirrhotic rat liver. Hepatology 18:1189–1197, 1993

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery II, Kumamoto University Medical School, Honjo 1-1-1, 860, Kumamoto, Japan

    Yasuo Yamaguchi MD, Nobuyuki Kikuchi MD, Nobutomo Miyanari MD, Osamu Ichiguchi MD, Mataro Goto MD, Katsutaka Mori MD &  Michio Ogawa MD

Authors
  1. Yasuo Yamaguchi MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nobuyuki Kikuchi MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nobutomo Miyanari MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Osamu Ichiguchi MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mataro Goto MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Katsutaka Mori MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Michio Ogawa MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

This work was supported in part by the Mika Memorial Fund for Medical Research at Kumamoto University Medical School.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Yamaguchi, Y., Kikuchi, N., Miyanari, N. et al. Technique for orthotopic reduced-size hepatic transplantation combined withex vivo liver cut down in the rat. Digest Dis Sci 41, 1713–1721 (1996). https://doi.org/10.1007/BF02088735

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02088735

Key words

Search

Navigation