Abstract
The animal model of the whole-size and reduced-size liver transplantation in both rat and mouse has been successfully established. Because of the difficulties and complexities in microsurgical technology, the animal model of dual liver transplantation was still not established for twelve years since the first human dual liver transplantation has been made a success. There is an essential need to establish this animal model to lay a basic foundation for clinical practice. To study the physiological and histopathological changes of dual liver transplantation, “Y” type vein from the cross part between vena cava and two iliac of donor and “Y’ type prosthesis were employed to recanalize portal vein and the bile duct between dual liver grafts and recipient. The dual right upper lobes about 45–50% of the recipient liver volume were taken as donor, one was orthotopically implanted at its original position, the other was rotated 180° sagitally and heterotopically positioned in the left upper quadrant. Microcirculation parameters, liver function, immunohistochemistry and survival were analyzed to evaluate the function of dual liver grafts. No significant difference in the hepatic microcirculatory flow was found between two grafts in the first 90 minutes after reperfusion. Light and electronic microscope showed the liver architecture was maintained without obvious features of cellular destruction and the continuity of the endothelium was preserved. Only 3 heterotopically positioned graft appeared patchy desquamation of endothelial cell, mitochondrial swelling and hepatocytes cytoplasmic vacuolization. Immunohistochemistry revealed there is no difference in hepatocyte activity and the ability of endothelia to contract and relax after reperfusion between dual grafts. Dual grafts made a rapid amelioration of liver function after reperfusion. 7 rats survived more than 7 days with survival rate of 58.3.%. Using “Y” type vein and bile duct prosthesis, we successfully established a novel rat model of dual right upper liver lobe transplantation.
Highlights
Liver transplantation is an effective treatment for end-stage liver disease, but a huge gap remains between the number of people that need a liver transplant and the number of organs available
Dual liver transplantation in clinical practice happens sporadically and there exists a significant gap in our knowledge regarding the physiological changes in these patients
The shortage of liver donors has put the patients at risk of dying on the waiting list for liver transplantation. New surgical techniques such as split liver transplantation and living donor liver transplantation play an important role in extending the donor pool, it can not be routinely carried out, especially when graft weight and volume can not meet the basic needs of recipient and when graft quality is marginal which can lead to small-for-size syndrome or primary non-function [9]
Summary
Liver transplantation is an effective treatment for end-stage liver disease, but a huge gap remains between the number of people that need a liver transplant and the number of organs available. In order to maximize donor organs, novel surgical techniques such as split liver and living donor transplantation have evolved [1]. Small for size syndrome is a major issue with single lobe liver grafts both in split and live donor liver transplantation. Animal models of whole orthotropic rat liver transplantation [2] and small-for-size liver transplantation [3] have been established to study this syndrome. In spite of the development of dual liver transplantation in Korea, China, and Japan (Table 1) [4,5,6,7,8], animal models to evaluate dual liver transplantation are still not to be established. We report the first rat model of dual liver transplantation
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