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KMID : 0371320080740040243
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Journal of the Korean Surgical Society
2008 Volume.74 No. 4 p.243 ~ p.247
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An Experimental Model of Partial Auto-liver Transplantation in Pig with Intrahepatic Inferior Vena Cava Reconstruction Using a GORE-TEXR Vascular Graft
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Seo Hyung-Il
Sim Mun-Sup
Kim Dong-Heon
Jeon Tae-Yong
Jo Hong-Jae
Kwon Jae-Young
Kim Hae-Kyu
Kim Hae-Young
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Abstract
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Purpose: Experimental animal models are useful training methods for liver transplantation, despite of ethical issues. The aims of this study are to examine the technical feasibility of living donor liver transplantation in pigs and to address the ethical problems.
Methods: Eight pigs were used in this experiment. The pig liver was divided via a left hemi-hepatectomy without inflow occlusion. The GORE-TEXR Vascular Graft was used as a replacement for the inferior vena cava during the graft. After the bench technique, the remnant right lobe of the pig was removed. During the anhepatic phase, an abdominal aortic clamp in combination with general hypothermia was applied, instead of using a conventional bypass procedure.
Results: Anhepatic time was 41.3±7.0 min and cold ischemic time was 200.3±29.4 min. The 1st, 4th, and 8th pig died because of declamping shock and arrhythmia on releasing the abdominal aortic clamp. Three pigs had five postoperative complications: pneumonia, gastrointestinal bleeding, IVC thrombosis, portal vein thrombosis, and bile duct stricture. The 6th pig received a hepaticojejunostomy due to stricture of the anastomosis site at 37 days after transplantation.
Conclusion: Pigs are economically and ethically more convenient compared to primate models. For auto-liver transplantation, no immunotherapy was needed. The pigs lived relatively long, allowing operative faults to be detected and studied. This experimental model will be useful training for living donor liver transplantation. (J Korean Surg Soc 2008; 74:243-247)
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KEYWORD
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Liver transplantation, Vascular graft, Pig
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