Description of a new auxiliary heterotopic partial liver transplantation technique with portal vein arteriolization of applicability in heterotopic liver xenotransplantation

• Published in: Transplantation proceedings 2003-08, Vol.35 (5), p.2051-2053
• Main Authors: Fernández-Rodríguez, O.M, Ríos, A, Montoya, M, Ramírez, P, González, F, Ruíz de Angulo, D, Conesa, C, Sánchez, A, García Palenciano, C, Pons, J.A, Parrílla, P
• Format: Article
• Language: English
• Subjects: Anastomosis, Surgical; Animals; Biological and medical sciences; Blood Flow Velocity; Disease Models, Animal; Liver Transplantation - methods; Liver, biliary tract, pancreas, portal circulation, spleen; Medical sciences; Portal Vein - surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Swine; Transplantation, Heterologous - methods; Vena Cava, Inferior - surgery
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/S0041-1345(03)00709-7

The aim of this study was to describe a new model of auxiliary heterotopic partial liver transplantation with portal vein arterialization. Three standard hepatectomies were performed in pigs. The left lateral lobe was surgically resected and portal vein arteriolization constructed by an end-to-side “Y” anastomoses between the distal to the celiac axis aorta and the portal vein. The graft was placed in the left iliaca fossa using anastomoses of the donor infrahepatic inferior cava vein end-to-side to the host infrarenal inferior vein and the donor aortic stump with portal vein arteriolization end-to-side to the left iliac artery. After graft reperfusion, the 3 recipients showed intraoperative hypotension, which was treated with fluid administration and vasoactive drugs. At the end of the operation, the graft displayed normal arterial blood flow and good venous drainage. The donor liver graft appeared more red than the host liver, which was due to the increased arterial blood flow. One pig of 3 died at 24 hours after surgery, probably due to hypothermia. However, the other 2 pigs survived the procedure and remained stable. Echographic monitoring showed intrahepatic arterial expansion, which may be the result of high blood pressure due to the arteriolization procedure. We have developed a novel and easy to perform technique that diminishes the number of anastomoses and does not involve vessels from other organs.