Improved two-cuff technique for orthotopic liver transplantation in rat

Abstract

Background: The first orthotopic liver transplantation in rat (ROLT) was reported by Lee in 1973. Kamada innovatively applied cuff technique to ROLT in 1979. However, the operative procedures were highly demanding and the operative mortality was relatively high. The purpose of this study was to improve the model of ROLT, simplify operative procedures, and enhance the successful rate of operation.

Methods: Orthotopic liver transplantation was performed in 160 Wistar rats by improved two-cuff technique. The portal vein between donor and recipient was anastomosed with the cuff technique. The same method was used to anastomose the infrahepatic vena cava. The suprahepatic vena cava and the hepatic artery were anastomosed by microvascular suturing and the bile duct was anastomosed end to end by a Teflon catheter.

Results: The average time for donor operation, graft preparation and anhepatic phase was 31 minutes, 14 minutes and 13 minutes, respectively. The anastomosis time for the suprahepatic vena cava, portal vein, infrahepatic vena cava, hepatic artery and bile duct was 7 minutes, 2 minutes, 2 minutes, 8 minutes and 1 minute, respectively. The main causes for operative mortality were pneumothorax, anesthesia, air embolism and massive bleeding, and the successful rate of operation was 92.5%. The causes for death after operation were stoma bleeding, infection, biliary obstruction and graft failure.

Conclusion: The improved two-cuff technique can reduce operative mortality, enhance survival rate, and serve as an ideal method for the establishment of animal model of ROLT.