Live donor partial liver harvest for canine liver transplantation: development of an innovative technique for surgical training and research.

Abstract

Most models of canine segmental liver transplantation use about 40% of the total liver volume including the left lateral and medial segments, an approach which is associated with some shortcomings. First, during live donor harvest, a necrotic segment requiring further resection is unavoidable after removal of the donor segments; and second, to harvest the left lobe, two dissection planes must be used. This creates some technical bias and limitations in designing a canine research model. Herein, we report a new technique of harvesting up to 70% of the liver in dogs. The right medial and quadrate segments, the left lobe, and the papillary process of the caudate lobe were resected and harvested for transplantation. We divided the middle hepatic vein to enable a single parenchymal dissection between the right medial and lateral segments and no perfusion defect was seen. Using this technique, we performed orthotopic autoauxiliary transplantation ( n = 6) and orthotopic alloauxiliary transplantation ( n = 5) in dogs. All dogs transplanted with an autograft were alive at the completion of surgery. All donor dogs providing 70% of the liver volume for allografts were alive 1 week after surgery, and all five allograft recipient dogs were alive 48 h after surgery, at which point they were killed. This novel experimental technique of partial living donor liver transplantation using about 70% of the liver allows for easier harvest and effective live donor partial liver transplantation. Moreover, the fact that division of the liver parenchyme can be done without leaving a necrotic segment shows the possibilities for various research models of ischemic-reperfusion injury. This technique allows us to divide the liver in situ, then subject the right segment of the liver to various insults or remedies for comparison.