Application of magnetic compression anastomosis in establishment of rat models of liver transplantation

Abstract

Objective Magnetic compression anastomosis (MCA) was adopted to substitute traditional suturing method and establish a sutureless and rapid anastomosis liver transplantation (LT) model, aiming to establish a favorable technical platform for studying LT-related problems in clinical practice. Methods A total of 300 healthy male SD adult rats (SPF grade), weighed 250-280 g, were evenly divided into the donors (n=150) and recipients (n=150). Based upon the two-cuff technique, the rat models of orthotopic LT were established by the reconstruction of suprahepatic inferior vena cava (SHVC) using MCA. Practice stages were subject to the early- (40 pairs), middle- (40 pairs) and advanced-stage (70 pairs). The operation time and postoperative 1-, 5-d survival rates of the rats during each stage were observed and recorded. The causes of surgical failure were analyzed to improve the surgical skills. Results The operation time of the donors was reduced from (45.0±5.0) min in the early stage to (22.0±3.0) min in the advanced stage. The anhepatic phase was reduced from (28.5±5.0) min to (11.8±3.1) min. The operation time of the recipients was reduced from (76.1±7.0) min to (47.7±2.9) min. The postoperative 1-, 5-d survival rate in the early-, middle- and advanced-stage was respectively 25%(10/40), 80%(32/40), 97%(68/70) and 5%(2/40), 45%(18/40), 83%(58/70). In the early-stage, the failure of the LT mainly resulted from long anhepatic phase, failure of portal vein (PV)-infrahepatic inferior vena cava (IHVC) anastomosis and excessive intraoperative hemorrhage. A majority of the recipients failed to complete the surgery or died at postoperative 2-4 h. During the middle- and advanced-stage, the failure of LT resulted from failed PV-IHVC anastomosis. Conclusions Modified MCA can rapidly anastomose the SHVC, enhance the success rate of LT, lower the difficulty and cycle of exercise for beginners and establish an ideal LT model. Key words: Liver transplantation; Rats; Magnetic compression anastomosis; Transplantation model