Auxiliary, heterotopic rat liver transplantation with arterialized portal vein in acute hepatic failure

Background: The aim of our work was to examine the effect of the portal vei n arterialization of an auxiliary liver graft on survival, liver function a nd regeneration of the native liver suffering from induced acute hepatic fa ilure. Methods: Lewis rats were operated on under ether inhalation anesthesia: in the control group (n = 10) an acute hepatic failure was induced by liver re section of about 85%. After a right side nephrectomy the auxiliary transpla ntation of a liver graft (resected by about 70%) into the right upper quadr ant of the abdomen was performed (trial group, n = 12). The portal vein was completely arterialized via the A. renalis dextra. The infrahepatic Vv. ca vae were anastomosed end-to-side and the bile duct was implanted into the d uodenum. Results: Survival rate in the trial group was 10/12 (control group 2/10). T he prothrombin time in the trial group rose up to 38 +/- 2 s on day 1 posto peratively (control group: 66 +/- 6 s); on day 5 postoperative it reached s tandard values of 30 +/- 1 s. The initial hepatobiliary scan demonstrated a good uptake of the liver graft as sign of normal liver function, whereas t he function of the native liver was distinctly reduced. Over the time cours e the function of the native liver recovered again. After three months the transplanted liver had atrophied (0,6% of body weight), whereas the native liver had hypertrophied (2,5% of body weight) - with a standard total weigh t of the liver of 3,1% of the body weight. Conclusion: The auxiliary liver transplantation with arterialized portal ve in secures survival of the animals in the phase of acute liver failure. In the further course the native liver regenerates, whereas the liver graft at rophies.