The experience in porcine orthotopic liver transplantation
Abstract
Orthotopic liver transplantation is the only way to cure patients with chronic liver failure. Increasing number of such patients, challenging surgical technique require supreme efforts from
entire operative team and surgeon personally. Study of technical pearls and pitfalls, acquisition
of adequate and fast reaction to complicated intraoperative complications are impossible without experimental surgery. In the article, the authors presented the first experience in orthotopic
liver transplantation with active veno-venous bypass in piglets. 48 hours survival was observed
in 55.6% of 9 operations.The authors analyzed technical details of surgery in piglets. Modified
sewing technique improving quality of anastomose is offered.
Keywords:orthotopic liver transplantation, veno- venous bypass
Clin. Experiment. Surg. Petrovsky J. 2017; 5 (1): 91–97.
DOI: 10.24411/2308-1198-2017-00026
Received: 19.05.2016. Accepted: 10.11.2016.
References
1. Gotie S.V., Konstantinov B.A., Tsirulnikova O.M. Liver transplantation: a guide for physicians.Moscow: Meditsinskoe informatsionnoe agentstvo, 2008: 248 р. (in Russian)
2. Lopukhin Yu.M. Experimental surgery. Moscow: Meditsina,
1971: 344 р. (in Russian)
3. Shumakov V.I., Moysyuk Yа.G., et al. The evolution of surgi-
cal techniques orthotopic liver transplantation. Vestnik transplantologhii i iskusstvennykh organov [Bulletin of Transplantology and
Artificial Organs]. 2006; (2): 18–23. (in Russian)
4. Busutti R.W., Klintmalm Goran B.G. Transplantation of the
Liver. 3rd ed. Elsevier, 2015.
5. Calleja K.J., Martin C.J., et al Combined small bowel and
reduced liver transplantation in pigs. Rev Esp Enferm Dig. 1997;
Vol. 89 (5): 375–84.
6. Calne R.Y., Yoffa D.E., et al. A Technique of orthotopic liver
transplantation in the pig. Br J Surg. 1968; Vol. 55 (3): 203–6.
7. David A.I., Chida V.V. , et al. Multivisceral transplantation
in pigs: a model for research and training. Einstein (Sao Paulo).
2011; Vol. 9 (3, Pt 1): 372–6.
8. Eisele P.H., Woodle E.S., et al. Anesthetic, preoperative and
postoperative considerations for liver transplantation in swine. Lab
Anim Sci. 1986; Vol. 36 (4): 402–5.
9. Esmaeilzadeh M., Nickkholgh A., et al. Technical guidelines
for porcine liver allo-transplantation: A review of literature. Ann
Transplant. 2012; Vol. 17 (2): 101–10.
10. Falcini F., Martini E., et al. Veno-venous bypass in experimental liver transplantation: portal-jugular versus caval-portal-jugular. Il Giornale di Chirurgia. 1990; Vol. 11 (4):
206–10.
11. Filipponi F., Benassai C. et al. Biliary tract complications in
orthotopic liver transplantation: an experimental study in the pig.
Ital J Surg Sci. 1989; Vol. 19 (2): 131–6.
12. Filipponi F., Falcini F., et al. Orthotopic liver transplant
in pigs: several variations of the surgical technic. Il Giornale
di Chirurgia. 1989; Vol. 10 (7–8): 374–8.
13. Flye M.W., Bishelli D. Atlas of Organ Transplantation. Philadelphia: W.B. Saunders, 1995.
14. Goto S. Orthotopic liver transplantation in miniature pigs:
some technical considerations in recipient. Nihon Geka Gakkai
Zasshi. 1988; Vol. 89 (2): 215–26.
15. Gruttadauria S., Marino G., et al. Porcine orthotopic liver
autotransplantation: facilitated technique. J Invest Surg. 2001;
Vol. 14: 79–82.
16. Guarrera J.V., Estevez J., et al. Hypothermic machine perfusion of liver grafts for transplantation: Technical development
in human discard and miniature swine models. Transplant Proc.
2005; Vol. 37: 323–5.
17. Heuer M., Reinhardt R. et al. Liver transplantation in swine
without venovenous bypass. Eur Surg Res. 2010; Vol. 45. P. 20–25.
18. Kaiser G.M., Heuer M.M. et al. General handling and anesthesia for experimental surgery in pigs. J Surg Res. 2006; Vol. 130: 73–9.
19. Kelly M.D., Demetris A.J., et al. Porcine partial liver transplantation: A novel model of the «small-for-size» liver graft. Liver Transpl. 2004; Vol. 10 (N 2): 253–63.
20. Kirk A.D., Knechtle S.J., et al. Textbook of Organ Transplantation. Hoboken, NJ: Wiley-Blackwell, 2014: 1794 p.
21. Mehrabi A., Fonouni H., et al. Current concepts in transplant surgery: liver transplantation today. Langenbecks Arch Surg.
2008; Vol. 393: 245–60.
22. Memsic L., Quinones-Baldrich W., et al. A Comparison
of Porcine Orthotopic Liver Transplantation Using a Veno-Venous
Bypass with and without Nonpulsatile Perfusion Pump. J Surg Res.
1986; Vol. 41: 33–40.
23. Pinna A.D., Ercolani G. Abdominal Solid Organ Transplantation. Immunology, Indications, Techniques, and Early Com-
plications. Switzerland: Springer International Publishing, 2015: 453 p.
24. Richer J.P., Silvain Ch. et al. Anatomic and radiologic bases of combined transplantation of liver and small intestine in the pig.
Surg Radiol Anat. 1994; Vol. 16: 245–51.
25. Spetzler V.N., Goldaracena N. et al. Technique of Porcine
Liver Procurement and Orthotopic Transplantation using an Active
Porto-Caval Shunt. J Vis Exp. 2015; Vol. 99. Article ID e52055.
26. Swindle M.M., Smith A.C. Best practices for performing experimental surgery in swine. J Invest Surg. 2013; Vol. 26: 63–71.
27. Swindle M.M., Smith A.C. Swine in the Laboratory. 3rd ed.
Taylor and Francis, 2016: 593 p.
28. Torres O.J.M., Pantoja P.B., et al. Hemodynamics alterations
during orthotopic liver experimental transplantation in pigs. Acta Cir
Bras. 2008; Vol. 23 (N 2): 135–9.