Simplified technique of orthotopic liver transplantation in pigs

Background Pig models have become common in transplantation immunological r esearch. However er, in pigs, clamping of the venous splanchnic system duri ng orthotopic liver transplantation (OLT) is responsible for high morbidity and mortality rates; therefore, the use of venovenous bypass (WB) is advoc ated. Because venous bypass can also cause specific complications, a simpli fied method for OLT in pigs has been developed and evaluated in terms of mo rbidity and mortality. Methods. Twenty-three OLTs were performed between pairs of inbred miniature swine. Donor and recipient pairs (weighing 20-35 kg) were selected at 3-6 months of age. in the donor, the portal rein, infrahepatic vena cava, and s uprahepatic vena cava were dissected whereas the hepatic artery was preserv ed in continuity with the coeliac trunk and the abdominal aorta up to the i liac bifurcation, in situ cold perfusion was then performed The recipient w as prepared simultaneously by another surgical team. After total hepatectom y and complete portal and caval clamping, the suprahepatic vena cava and po rtal vein were sutured; WE was not used. After completion of both venous su tures, the liver graft was reperfused. The infrahepatic vena cava was then anastomosed and unclamped The donor aorta conduit was implanted end-to-side to the recipient infrarenal aorta, and the biliary reconstruction consiste d of a cholecystojejunostomy with a Roux-Y loop. Results, Twenty of 23 (87%) animals survived more than 1 week (7-483 days). The mean anhepatic time was 29.6+/-4.12 min. Although severe hypotension w as noted during the anhepatic phase, the hemodynamic status rapidly recover ed and stabilized after graft reperfusion. Conclusion. Simplified technique without VVB is appropriate for successfully achieving OLT in pigs.