New Technique of Experimental Partial Liver Transplantation: Hemodynamic Study During Surgery

Abstract

Orthotopic liver transplantation of children is often limited by the scarcity of an appropriately size-matched donor organ. The transplantation of a reduced liver was thus conceived to solve this problem. A new technique of partial liver transplantation in mongrel dogs is reported, which partially retains the recipient's liver and uses an Ameroid constrictor to occlude the recipient's portal branch gradually. The donor's right and median lobectomy was performed in situ. The donor's left lobe was perfused in situ and removed as a graft. It was then transplanted orthotopically in the space after a left and median lobectomy of the recipient. An Ameroid constrictor was applied around the recipient's right portal branch for a gradual occlusion of the host hepatic blood supply (the Ameroid group). To compare the hemodynamic stability during surgery with this technique, two other methods were also performed. The mean systemic blood pressure of orthotopic liver transplantation with a passive venovenous bypass during the anhepatic period (the Bypass group, n= 5) was lower than that of the Ameroid group (n= 16). Instead of fitting an Ameroid constrictor, an orthotopic partial liver transplantation with ligation of the right portal branch (the Ligation group) was performed. The mean systemic blood pressure of the Ligation group (n= 10) was lower than that of the Ameroid group (n= 11) after either fitting a constrictor or performing a ligation. This method has two advantages: One is the availability of the reduced graft; the other is that an extracorporeal bypass of the portal blood and vena caval blood is unnecessary. Therefore, the hemodynamic stale becomes stable. Furthermore, it can protect against the functional competition between the graft and the host liver.

Key Words:

• Keywords Liver transplantation
• dog
• portal vein