Auxiliary liver transplantation in acute liver failure in the rat - an illustrated description of a new surgical approach

Schleimer, Karina; Länge, R.; Rauen, Ursula; Erhard, J

doi:10.1007/s004230050193

Cited by 10 publications

(11 citation statements)

References 6 publications

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“…In four cases (mean age 52 years), the portal vein was re-vascularized by complete PVA; in the fifth patient, a portocaval transposition was carried out [13]. In three of the arterialized patients, the PVT had been diagnosed before transplantation by means of duplex-ultrasonography and/or angiography.…”

Section: Patientsmentioning

confidence: 99%

Outcome of patients with pre-existing portal vein thrombosis undergoing arterialiazation of the portal vein during liver transplantation

Ott¹,

Böhner²,

Müller³

et al. 2003

Transplant Int

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Arterialization of the portal vein is being propagated as a technical possibility in liver transplant recipients with pre‐existing portal vein thrombosis. In our own small sries, portal vein arterialization (PVA) was carried out in four patients undergoing orthotopic liver transplantation. In three of these cases, the portal vein was anastomosed to the aorta via an interposed iliac artery, and in one case, directly to the hepatic artery. After PVA, all transplants showed regular initial function. Two patients died postoperatively afer 19 and 50 days, of intra‐abdominal haemorrhage and liver necrosis with thrombosis of the portal vein, respectively. A further patient had previously developed fibrosis of the liver, which led to the death of the patient 11 months after PVA. In the remaining patient, chronic rejection requiring re‐transplantation developed 24 months after PVA had been performed. These unfavourable results prompt the conclusion that PVA cannot be recommended as a stndard clinical procedure.

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Section: Patientsmentioning

confidence: 99%

Outcome of patients with pre-existing portal vein thrombosis undergoing arterialiazation of the portal vein during liver transplantation

Ott¹,

Böhner²,

Müller³

et al. 2003

Transplant Int

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“…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.…”

Section: Discussionmentioning

confidence: 99%

“…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].…”

Section: Discussionmentioning

confidence: 99%

A Novel Auxiliary Partial Orthotopic Liver Transplantation Model in Rats

et al. 2000

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Background: Although auxiliary partial orthotopic liver transplantation (APOLT) has become a well-accepted procedure recently, a practical experiment model in APOLT using small animals has yet to be developed. Methods: Male Lewis rats were used for both donors and recipients. An auxiliary partial graft was obtained by ex vivo resection of the donor right and caudate lobes, and was transplanted orthotopically into the recipient after resection of the recipient medial and left hepatic lobes. Portal vein and hepatic duct reconstructions were by the cuff technique, and supra- and intrahepatic vena cava were sutured continuously. Operative outcomes, serum chemistry, liver tissue blood flow, angiographic and histopathological findings were then examined. Conventional orthotopic liver transplantation (OLT) procedures were also undertaken as a control. Results: One-day, 1-week and 1-month survival rate of APOLT group was 100, 85 and 85%, respectively. AST in the APOLT group on the 1st postoperative day was significantly higher than in the OLT group. No significant differences were recognized in serum albumin and total bilirubin levels between the two groups. Although the portogram of an APOLT rat showed slight narrowing at the cuff anastomosis site, both the graft and the native liver were opacified similarly. The liver tissue blood flow on the 5th postoperative day in the native liver and the graft returned to as high as 95 and 74% of the values on laparotomy, respectively. Histological examinations of the auxiliary graft 1 month after transplantation showed mild ductular proliferation and mononuclear cell infiltration around the portal triads. Conclusion: This novel APOLT model in rats allows practical and reproducible results, and may be of value in the basic study of APOLT procedures.

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“…In previous experiments, we performed heterotopic auxiliary liver transplantation (HALT) with PVA in acute hepatic failure, but we did not examine or regulate the portal vein flow [5,6]. The hepatic artery was not reconstructed, and the bile duct was implanted into the duodenum using the pull-through technique.…”

Section: Introductionmentioning

confidence: 99%

Improved technique of heterotopic auxiliary rat liver transplantation with portal vein arterialization

Schleimer

Stippel

Tawadros

et al. 2006

Langenbecks Arch Surg

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Auxiliary liver transplantation in acute liver failure in the rat - an illustrated description of a new surgical approach

Cited by 10 publications

References 6 publications

Outcome of patients with pre-existing portal vein thrombosis undergoing arterialiazation of the portal vein during liver transplantation

Outcome of patients with pre-existing portal vein thrombosis undergoing arterialiazation of the portal vein during liver transplantation

A Novel Auxiliary Partial Orthotopic Liver Transplantation Model in Rats

Improved technique of heterotopic auxiliary rat liver transplantation with portal vein arterialization

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