Allogeneic Venous Grafts of Different Origin Used for Portal Vein Reconstruction After Pancreaticoduodenectomy - Experimental Study

• Published in: Anticancer research 2019-12, Vol.39 (12), p.6603-6620
• Main Authors: Palek, Richard, Jonasova, Alena, Rosendorf, Jachym, Mik, Patrik, Bajcurova, Kristyna, Hosek, Petr, Moulisova, Vladimira, Eberlova, Lada, Haidingerova, Lenka, Brzon, Ondrej, Bednar, Lukas, Kriz, Tomas, Dolansky, Martin, Treska, Vladislav, Tonar, Zbynek, Vimmr, Jan, Liska, Vaclav
• Format: Article
• Language: English
• Subjects: Allografts; Anastomosis, Surgical - methods; Animals; Biochemical analysis; Cadaver; Clinical medicine; Computer Simulation; Female; Grafting; Grafts; Hemodynamics; Male; Mathematical models; Medicine; Organ Size; Organ Sparing Treatments; Pancreaticoduodenectomy; Portal vein; Portal Vein - anatomy & histology; Portal Vein - diagnostic imaging; Portal Vein - physiology; Portal Vein - surgery; Postoperative Complications - etiology; Pylorus; Reconstruction; Reconstructive Surgical Procedures - methods; Regional Blood Flow; Swine; Thromboembolism; Thrombosis; Tissue and Organ Harvesting; Transplantation; Ultrasonography; Ultrasound; Vena Cava, Inferior - anatomy & histology; Vena Cava, Inferior - diagnostic imaging; Vena Cava, Inferior - physiology; Vena Cava, Inferior - transplantation; Venous Thrombosis - etiology
• ISSN: 0250-7005; 1791-7530
• DOI: 10.21873/anticanres.13876

In clinical medicine, little is known about the use of allografts for portal vein (PV) reconstruction after pancreaticoduodenectomy (PD). Portal and caval systems are physiologically different, therefore the properties of allografts from caval and portal systems were studied here in a pig model. PD with PV reconstruction with allogeneic venous graft from PV or inferior vena cava (IVC) was performed in 26 pigs. Biochemical analysis and ultrasonography measurements were performed during a 4-week monitoring period. Computer simulations were used to evaluate haemodynamics in reconstructed PV and explanted allografts were histologically examined. The native PV and IVC grafts varied in histological structure but were able to adapt morphologically after transplantation. Computer simulation suggested PV grafts to be more susceptible to thrombosis development. Thrombosis of reconstructed PV occurred in four out of five cases in PV group. This study supports the use of allografts from caval system for PV reconstruction in clinical medicine when needed.