ARTERIALIZATION OF THE PORTAL-VEIN OF THE TRANSPLANTED LIVER IN THE GOTTINGER MINIATURE PIG

The aim of the present experimental investigation was to assess the ci rculatory, biochemical and histopathological consequences of complete portal vein arterialization of the transplanted liver in 'Gottinger' m iniature pigs. Orthotopic liver transplantations using a passive porto jugular shunt were performed in six male 'Gottinger' performed pigs. U sing an iliac artery segment interposition of the animal donor, the he patic artery (HA) of the transplant liver was anastomized end-to-end a nd the portal vein (PA) also united with the internal iliac artery stu mp end-to-end. The central anastomosis was performed onto the supraren al aorta. Portal vein blood was drained into the infrahepatic caval ve in via an end-to-side shunt (PCS). During the course, the following pa rameters were determined arterial blood pressure, venous pressure, car diac output, electromagnetic blood flow measurements across the HA, PA , and PCS, PA mean pressure, transaminases, partial thromboplastin tim e and fibrinogen. Liver biopsies and autopsy specimens were investigat ed. One of six animals died a few hours postoperatively, two of six di ed after 48 and 72 h, respectively, whereas three pigs survived the sc heduled 7 days. The cardiac output fell intraoperatively initially by an average of 20 % but had approximately the starting volume of 2.2 1/ min at the end of the operation. Although the diameter of the anastomo sis was reduced to 4 mm, the flow in the arterialized PA on average wa s 340 ml/min when the vessel clamp was opened. At the end of operation the mean was 380 ml/min, the interval of measurement being 75 min. Th e flow across the PCS and the HA were constant during the course. As m echanism for this phenomenon, autoregulation of the liver blood flow o n a sinusidal level has been suggested. The biochemical results and th e histopathological findings showed no change compared to previous fin dings in a control group of animals in which liver transplantion was p erformed by our team. Complete arterialization of the PA is well toler ated in liver transplantation in 'Gottinger' miniature pigs with regar d to circulation and liver function in a short-term trial of a maximum of 7 days. Long-term results are still to come.