Comparative Anatomical Study Between the Human and Swine Liver and Its Importance in Xenotransplantation

Ntonas, Athanasios; Katsourakis, Anastasios; Galanis, Nikiforos; Filo, Eva; Noussios, George

doi:10.7759/cureus.9411

Cited by 12 publications

(14 citation statements)

References 17 publications

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“…All animal procedures were approved by the Children's National Hospital Institutional Animal Care and Use Committee (IACUC protocol #30591) and performed in accordance with all relevant regulations regarding animal use in research. Twenty‐five to 30 kg Yorkshire pigs were chosen for this surgery due to the similarities between human and pig liver anatomy 44 . Animal care and preparation for surgery were performed as described in previous work 21 .…”

Section: Methodsmentioning

confidence: 99%

Assessment of a novel biliary‐specific near‐infrared fluorescent dye (BL‐760) for intraoperative detection of bile ducts and biliary leaks during hepatectomy in a preclinical swine model

et al. 2023

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Objectives: Postoperative bile leakage is a common complication of hepatobiliary surgery and frequently requires procedural intervention. Bile-label 760 (BL-760), a novel near-infrared dye, has emerged as a promising tool for identifying biliary structures and leakage, owing to its rapid excretion and strong bile specificity. This study aimed to assess the intraoperative detection of biliary leakage using intravenously administered BL-760 compared with intravenous (IV) and intraductal (ID) indocyanine green (ICG). Materials and Methods: Laparotomy and segmental hepatectomy with vascular control were performed on two 25-30 kg pigs. ID ICG, IV ICG, and IV BL-760 were administered separately, followed by an examination of the liver parenchyma, cut liver edge, and extrahepatic bile ducts for areas of leakage. The duration of intra-and extrahepatic fluorescence detection was assessed, and the target-to-background (TBR) of the bile ducts to the liver parenchyma was quantitatively measured. Results: In Animal 1, after intraoperative BL-760 injection, three areas of leaking bile were identified within 5 min on the cut liver edge with a TBR of 2.5-3.8 that was not apparent to the naked eye. In contrast, after IV ICG administration, the background parenchymal signal and bleeding obscured the areas of bile leakage. A second dose of BL-760 demonstrated the utility of repeated injections, confirming two of the three previously visualized areas of bile leakage and revealing one previously unseen leak. In Animal 2, neither ID ICG nor IV BL-760 injections showed obvious areas of bile leakage. However, fluorescence signals were observed within the superficial intrahepatic bile ducts after both injections. Conclusions: BL-760 enables the rapid intraoperative visualization of small biliary structures and leaks, with the benefits of fast excretion, repeatable intravenous administration, and high-fluorescence TBR in the liver parenchyma. Potential applications include the identification of bile flow in the portal plate, biliary leak or duct injury, and postoperative monitoring of drain output. A thorough assessment of the intraoperative biliary anatomy could limit the need for postoperative drain placement, a possible contributor to severe complications and postoperative bile leak.

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Section: Methodsmentioning

confidence: 99%

Assessment of a novel biliary‐specific near‐infrared fluorescent dye (BL‐760) for intraoperative detection of bile ducts and biliary leaks during hepatectomy in a preclinical swine model

et al. 2023

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“…The biliary systems of humans and pig are similar in several aspects including anatomy and function. The only difference is that the drainage of segment I is performed by the sinister hepatic duct in humans, whereas the segment I is drained by the dexter hepatic duct in pigs 7 . The animals were acclimated in our facility for at least 24 h and fasted for 12 h before surgery.…”

Section: Methodsmentioning

confidence: 99%

“…The only difference is that the drainage of segment I is performed by the sinister hepatic duct in humans, whereas the segment I is drained by the dexter hepatic duct in pigs. 7 The animals were acclimated in our facility for at least 24 h and fasted for 12 h before surgery. Each pig was intubated and placed under isoflurane anesthesia before being positioned in the left lateral decubitus position.…”

Section: Animal Studymentioning

confidence: 99%

Laparoscopic cholecystectomy in a swine model using a novel near‐infrared fluorescent IV dye (BL‐760)

Cho

Nam

et al. 2021

Lasers Surg Med

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Background and ObjectivesBile duct injury during laparoscopic cholecystectomy has an incidence rate of 1%–2% and commonly appears under conditions of severe inflammation, adhesion, or unexpected anatomical variations. Despite the difficulties and rising concerns of identifying bile duct during surgeries, surgeons do not have a specific modality to identify bile duct except intraoperative cholangiography. While no biliary‐specific fluorescent dye exists for clinical use, our team has previously described the development of a preclinical biliary‐specific dye, BL‐760. Here, we present our study of laparoscopic cholecystectomy using the fluorescent dye in a swine model.Study Design/Materials and MethodsWith an approval from Institutional Animal Care and Use Committee, two 20–25 kg swine underwent laparoscopic abdominal surgery using a Food and Drug Administration‐cleared fluorescent laparoscopic system. Images of the liver and gallbladder were taken both before and after intravenous injection of the novel fluorescent dye. The dye was dosed at 60 μg/kg and injected via the ear vein. The amount of time taken to visualize fluorescence in the biliary tract was measured. Fluorescent signal was observed after injection, and target‐to‐background ratio (TBR) of the biliary tract to surrounding cystic artery and liver parenchyma was measured.ResultsBiliary tract visualization under fluorescent laparoscopy was achieved within 5 min after the dye injection without any adverse effects. Cystic duct and extrahepatic duct were clearly visualized and identified with TBR values of 2.19 and 2.32, respectively, whereas no fluorescent signal was detected in liver. Cystic duct and artery were successfully ligated by an endoscopic clip applier with the visual assistance of highlighted biliary tract images. Laparoscopic cholecystectomy was completed within 30 min in each case without any complications.ConclusionsBL‐760 is a novel preclinical fluorescent dye useful for intraoperative identification and visualization of biliary tract. Such fluorescent dye that is exclusively metabolized by liver and rapidly excreted into biliary tract would be beneficial for all types of hepato‐biliary surgeries. With the validation of additional preclinical data, this novel dye has potential to be a valuable tool to prevent any iatrogenic biliary injuries and/or bile leaks during laparoscopic abdominal and liver surgeries.

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“…Porcine organs which are not sold for consumption (liver and lung) are highly accessible and cost effective for our bioengineered application presented here. Porcine livers, 35,36 lungs 37,38 and other tissues have been characterized to show proximity to human tissues across many criteria including mechanical properties, anatomical structure and ECM protein composition and as such have been developed as biomedical models of a variety of diseases such as cancer. An additional strength in our in vitro model is the repopulation of decellularized biomatrices with 3D tumor spheroids generated on hanging drop arrays.…”

Section: Introductionmentioning

confidence: 99%

Decellularized organ biomatrices facilitate quantifiable in vitro 3D cancer metastasis models

et al. 2022

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Comparative Anatomical Study Between the Human and Swine Liver and Its Importance in Xenotransplantation

Cited by 12 publications

References 17 publications

Assessment of a novel biliary‐specific near‐infrared fluorescent dye (BL‐760) for intraoperative detection of bile ducts and biliary leaks during hepatectomy in a preclinical swine model

Assessment of a novel biliary‐specific near‐infrared fluorescent dye (BL‐760) for intraoperative detection of bile ducts and biliary leaks during hepatectomy in a preclinical swine model

Laparoscopic cholecystectomy in a swine model using a novel near‐infrared fluorescent IV dye (BL‐760)

Decellularized organ biomatrices facilitate quantifiable in vitro 3D cancer metastasis models

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