This study aimed to develop a new experimental model of liver cirrhosis in swine by using carbon tetrachloride (CCl₄) and ethanol. Liver cirrhosis was induced by intraperitoneal injection of CCl₄ twice a week for 9 weeks. Maize flour was the only food provided and the animals drunk a 5% alcohol-water mixture. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin, bilirubin and portal venous pressure (PVP) levels were determined throughout CCl₄ treatment. The animals were sacrificed under general anesthesia at week 9 and liver samples were collected for histological analysis. 83.3% of the swine had liver cirrhosis and 33.3% had died. There was no change of body weight during the course of the experiment (p > 0.05). The AST and ALT levels increased significantly in the early stage of the study but had a trend to decrease during the late phase. The level of bilirubin increased greatly and albumin decreased during the whole experiment (p < 0.05). PVP levels decreased in the early stage in CCl₄-treated swine, but increased significantly at the late phase. In conclusion, this study was successful in producing liver cirrhosis and offers an ideal experimental model for observing surgical therapeutic efficacy.

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Liver dual arterial blood supply (LDABS) could increase blood supply to the liver and maintain normal liver regeneration in patients with compromised portal vein. The current study attempted to examine the underlying molecular mechanisms. Male Sprague-Dawley rats randomly received partial hepatectomy (PH) alone or PH followed by LDABS. Liver regeneration was assessed by histological examination, liver function and liver regeneration rate (LRR). Whole-genome oligo microarray analysis was used to compare gene expression profile between rats receiving PH and rats receiving PH plus LDABS. Key genes identification was validated using a MAPK signaling polymerase chain reaction (PCR) array. The extent of liver regeneration in rats receiving PH plus LDABS was comparable to that in rats receiving PH alone. The differentially expressed genes were enriched in 12 signaling pathways in two groups. MAPK signaling pathway, NF-kappa B signaling pathway, and Toll-like receptor signaling pathway were involved in LDABS-mediated liver regeneration, with Retinoblastoma 1 (Rb1), Cyclin D1, Cyclin-dependent kinase 4, Mitogen-activated protein kinase 10 (Mapk10) and CAMP responsive element binding protein 1 genes in the initiation phase, Kirsten rat sarcoma viral oncogene homolog (Kras), tumor protein 53, MYC proto-oncogene, BHLH transcription factor, Cyclin E1 and Heat shock protein family B (small) member 1 genes in the proliferation phase, Kras, Rb1, Jun proto-oncogene, AP-1 transcription factor subunit, Cyclin D2 and Mapk10 genes in the termination phase were identified as key genes in LDABS-mediated liver regeneration using MAPK signaling PCR array analysis.

Portocaval shunt in rats is widely used for experimental studies of hepatic diseases, 1-3 as well as for microsurgical training. 4 Suture-based anastomosis is technically challenging due to the small diameter, thinness, and deep location of the portal and renal veins in porto-renal anastomosis for portocaval shunt. "Back wall biting" caused by blood vessel collapse is a common cause of failure in the microvascular anastomosis. 5 Here, we report an assisting suspension triangulated continuous suture (ASTCS) technique to prevent back wall biting in end-to-end porto-renal anastomosis for portocaval shunt in rats.Briefly, the major trunk of the portal vein was isolated using an operating microscope under isoflurane anesthesia. The right renal artery was isolated and clamped. The right renal vein was ligated with 0-gauge silk suture adjacent to the infrahepatic caval vein. The right kidney was removed. The blood flow through the portal vein was blocked by ligation at both ends, and the major trunk of the portal vein was dissected. The proximal end of the portal vein was connected with the right renal artery using a stent method, and the distal end of the portal vein was anastomosed with the right renal vein in an end-to-end pattern with 10-0 nylon suture using the ASTCS technique (Fig. 1).The anastomosis was started with 3 whole-layer eversion stitches at 4, 8, and 12 o'clock positions. The suture at the 8 o'clock position was used to perform subsequent continuous eversion stitching. The guide sutures at 8 and 12 o'clock positions were pulled upward; the guide suture at the 4 o'clock position was pulled downward with the gravity of vascular clip. When stitching reached the 12 o'clock position, continuous stitching was carried out before the guide suture at the 8 o'clock position was managed with a vascular clip. Likewise, continuous stitching at the 4 o'clock position was carried out after clipping the guide suture at the 12 o'clock position. We believe that the ASTCS technique is a convenient method to prevent back wall biting in end-to-end portorenal anastomosis for portocaval shunt in rats. Figure 1. Assisting suspension triangulated continuous suture (ASTCS) technique.

Auxiliary partial heterotopic liver transplantation (APHLT) with portal vein arterialization is a valuable procedure to be considered in the treatment of patients with acute liver failure and metabolic liver diseases. The aim of this study was to develop a new rat model of APHLT with liver dual arterial blood supply (LDABS). A total of 20 rats were used. The donor liver was resected, and the celiac trunk was reserved. Left and medial hepatic lobes accounting for 70% of the liver mass were removed en bloc and the suprahepatic caval vein was ligated simultaneously. Thus, 30% of the donor liver was obtained as the graft. Sleeve anastomosis of the graft portal vein and splenic artery were performed after narrowing the portal vein lumen through suturing. The right kidney of the recipient was removed, and sleeve anastomosis was performed between the celiac trunk of the graft and the right renal artery of the recipient. In addition, end-to-end anastomosis was performed between the infrahepatic caval vein of the graft and the right renal vein of the recipient. Following the reperfusion of the graft, the blood flow of the arterialized portal vein was controlled within the physiological range through suturing and narrowing under monitoring with an ultrasonic flowmeter. The bile duct of the graft was implanted into the duodenum of the recipient through an internal stent catheter. A 70% section of the native liver (left and medial hepatic lobes) was resected using bloodless hepatectomy. The mean operative duration was 154.5±16.4 min, and the warm and cold ischemia times of the graft were 8.1±1.1 min and 64.5±6.6 min, respectively. The blood flow of the arterialized portal vein to the graft was 1.8±0.3 ml/min/g liver weight. The success rate of model establishment (waking with post-surgical survival of >24 h) was 70% (7/10). Following successful model establishment, all rats survived 7 days post-surgery (100%; 7/7). The graft was found to be soft in texture and bright red in color following exploratory laparotomy. In conclusion, a new rat model of APHLT with LDABS without stent for vascular reconstruction was developed. This is a feasible and reliable rat model for liver transplantation study.