J Korean Surg Soc.  2008 Apr;74(4):243-247.

An Experimental Model of Partial Auto-liver Transplantation in Pig with Intrahepatic Inferior Vena Cava Reconstruction Using a GORE-TEX(R) Vascular Graft

• Seo HI
• Sim MS
• Kim DH
• Jeon TY
• Jo HJ
• Kwon JY
• Kim HK
• Kim HY

Abstract

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-TEX(R) 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 1(st), 4(th), and 8(th) 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.

Keyword

Liver transplantation; Vascular graft; Pig

MeSH Terms

Arrhythmias, Cardiac
Bile Ducts
Cold Ischemia
Constriction, Pathologic
Hemorrhage
Humans
Hypothermia
Immunotherapy
Liver
Liver Transplantation
Living Donors
Models, Animal
Models, Theoretical
Pneumonia
Portal Vein
Primates
Shock
Swine
Thrombosis
Transplants
Vena Cava, Inferior