Simplified Technique of Orthotopic Liver Transplantation in Pigs1

Abstract

Simplified technique without VVB is appropriate for successfully achieving OLT in pigs.

Experimental Liver Transplantation

“…After liver removal, donor's suprahepatic inferior vena cava is prepared for anastomosis by trimming the remnant liver parenchyma (Figure 7). Although models without the usage of bypass were described by some authors (Oike et al, 2001), our previous results were better when the bypass was used. (Sirbu Boeti et al, 2008) After its back table preparation, the donor liver is properly placed and oriented into the right subphrenic space.…”

“…Venovenous bypass is associated with an increased risk of bleeding, disorders of coagulation, air embolism, and venous thromboembolism. (Oike et al, 2001) The anesthetized animal is placed on its back, the skin is prepared and the draping is made so as to allow the left cervical access to jugular veins and the midline abdominal incision. The operation begins with the dissection and cannulation of the left external jugular vein.…”

“…The arterial reconstruction can also be made using an aortic graft sutured end-to-side to the infrarenal aorta (Figure 16). (Oike et al, 2001;Oldhafer et al, 1993) The cuff technique can also be used for arterial reconstruction. (Monden et al, 1982) A technique of orthotopic liver transplantation in the pig was described in which the main feature is the accomplishment of vascular anastomoses by the use of the Vogelfanger NRC vascular suturing instrument.…”

Hemodynamics alterations during orthotopic liver experimental transplantation in pigs

“…Although such technique is attractive, Gruttadauria et al 7 demonstrated that anhepatic phase without venovenous could be easily tolerated during a 30-min period, which is usually sufficient to perform the two venous sutures preceding graft revascularization. Clamping of the supracoeliac aorta produced a significant liver injury compared with the control group 4,5,6,8,13,15,16,17,18,28 .…”

“…Our model also allowed us to undertake some physiological studies during the transplantation procedure. This technique is not only similar to the procedure applied to man, but it also provides a safe and reproducible experimental model 4,5,12,16,21 . The aim of the study was to monitor metabolic changes in the liver graft over time during transplantation in a pig model.…”