Arterialization of the portal vein in liver transplantation: A new microsurgical model in the rat

Background. A preexisting thrombosis of the portal vein and the deep splanc hnic bed can make it extremely difficult to reestablish the portal blood fl ow in orthotopic liver transplantation in man. Complete arterialization of the liver transplant, including the donor portal vein, might be a viable th erapeutic option. A new rat transplantation model is described, in which th e liver is completely arterialized. Methods. The outflow of the portal blood in the recipient was secured via a portocaval shunt. Hepatectomy was then performed and the liver transplant placed in orthotopic position. An interposed aortic segment was used for di rect arterialization of the donor portal vein. Results. The laboratory parameters determined in the serum at the end of th e observation period of 28 days revealed normal functioning of the transpla nt, The histological examinations showed largely normal cellular architectu re, with no signs of necrosis, but incipient fibrosis. Conclusions. Using this new surgical technique in the rat liver transplanta tion model, long-term morphological and functional. changes in a completely arterialized liver graft, and the regenerative capability of liver tissue perfused in this way, can be investigated.