A New Swine Model Of Auxiliary Heterotopic Liver Transplantation

Liver transplantation is an important and basic treatment for the end-stage liver disease. But OLT (Orthotopic Liver Transplantation) is so complicated and always does severe damages to the recipient, some patients may need ALT (Auxiliary Liver Transplantation). Of ALT, AOLT (Orthotopic Auxiliary Liver Transplantation) has the same defects as OLT, and there are problems in AHLT (Heterotopic Auxiliary Liver Transplantation) for example graft failure or functional competition. So, it's important to find a simple form of AHLT after which the graft can get a long-term living.Object: To build an AHLT swine model with simple operation, similar normal construction, small effect to body and long-term alive graft. The model then can be used to treat end-stage liver disease and basic research of liver transplantation.Method: Get and repair the total or partial donor liver as the graft. Remove the recipient's spleen and put the graft in the space. Then end-to-end anastomose of the graft's portal vein to recipient's splenic vein; end-to-end anastomose of the graft's hepatic artery to the recipient's splenic artery, end-to-side anastomose of the graft's infra-hepatic vena cava to the recipient's left renal vein; Supra-hepatic vena cava ligated and common bile duct incubated for exo-drainage. Post-operative mortality, hepatic function, bile secretion, growth of liver cell are monitored. Necropsy is down when unexpected death or 7 days post-operative artificial death happen, the original and graft liver are pathologically examined.Result: Nine couples were treated and the one-week mortality was 22.2%(2/9). The survivors had normal liver function, bile secretion; one-week necropsy revealed one graft atrophy and one original liver atrophy, other showed active growth. One of the unexpected death recipient caused by metabolism disorder while with a almost normal graft, the other one by infection of the graft's bile duct, the graft also got an portal thrombosis. No rejection recipient observed.Conclusion: This AHLT model have simple procedure, strong repeatability, high survival rate, active graft growth, and gratify to the basic research of liver transplantation. It also shows a new way for the treatment of portal hypertension and cirrhosis.