A Method To Establish Heterotopic Auxiliary Liver Transplantation In Spleen Fossa With Splenectomy In Rat

Objective To establish a animal model of heterotopic auxiliary liver transplantation in spleen fossa with splenectomy in rat and with portal vein arterialization (PVA). To observate the survival rate of the postoperative rats. To study the effects of graft liver in supportting acute liver failure(ALT) and to study the effect of hepaticartery blood supply of portal vein to the early graft function in rats. And to observe the morphology change of the recipient's liver and graft liver.Method Healthy SD rats (unlimiting female and male) undergoing 85% partial hepatectomy were divided randomly into two groups as follows: group A (n=30) after a left nephrectomy and lienectomy, the graft liver, which was reduced to about 30% of the original size, was implanted into the left upper quadrant of the recipient's abdomen. The infraheoatic caval vein was anastomosed with the recipient's left renal vein by end-to-end using stent technique; The donor's portal vein was completely arterialized to the recipient's right renal artery Using a stent with an internal diameter of 0．3mm, the flow of the arterialized portal vein was regulated to achieve physiologic parameters. The bile duct was implanted into the duodenum of recipient applying a purse-string suture. Group B control group (n=10) only a left nephrectomy and lienectomy was operated. Observating the rat's survival rate of group A and group B. And detected the blood-serum of group A 1d,3d,5d,7d after the operation; detected the blood-serum of group B 1d after the operation. Executed the survival rats and take out of the graft liver and original liver to make pathological section, the shape and histological change of the livers was studyed.Results During the learning phase, the rats in group A, 1 recipients died ?intraoperatively from hemorrhoea; 2 recipient died 4 hours postoperatively fromhaemorrhage; 2 recipients died 48 hours postoperaively of peritonitis due to leakageof the bile-duct anastomosis and entero-obstruction; 3 recipients died after 3daysbecause of portal vein phlebothrombosis of graft liver. And 1 recipient died fromunrealized reason. 21 recipients survived over a week, the a week survival rate is 70%.The rats in group B: 2 rats died in 8 hours, 6 rats died in 48 hours and 2 rats survivedover one week. Liver function detecting: the parameter of ALT,AST,PT,Tbil of therats in group A degraded obviously, the parameter approach to the normal valuegradually with time variancing. The liver function number after 1 week was obviouslydecreased compare to the number after 1 day(P<0．5) ; The liver function number ingroup A after 1 week was obviously decreased compare to the number in groupB(P<0．5) . We found that the volume of remnant liver in group A increased in extentand the graft liver have no change in the shape. Under microscope we found that theremnant liver cell hyperplased obviously and a bit of achroacyte infiltrated the portalarea of the graft liver in group A; The liver cell of graft liver have no hyperplasy andapoptosis in histological anatomy. The volum of remmant liver in group B alsoincreased in extent.Conclusion:1,We established a animal model of heterotopic auxiliary liver transplantation in spl-een fossa with splenectomy and with portal vein arterialization (PVA) in rat successfully. And we explored a new feasible method to established heterotopic auxiliary liver transplantation animal model.2,After a week, the remmant liver cell begain to regenerate and it's volum increased in extent. The graft liver have not varianced obviously in short time during the recipient's liver function recovered.3,The graft liver provides an exact support role for the rat with acute liver failure (ALF) and makes the rats pass the earlier period of acute liver failure(ALF).4,Because the bile duct and portal vein etal important construction of original liver are left untouchued in our experiment, which also provide us a new thinking approach for liver transplantation in clinic. 5,In this experiment we have only researched the effect of graft liver to acute liver failure(ALF) in short period in rats. But the effect in long period of graft liver to acute liver failure(ALF) and the hyperplasy,atrophia relation and bloodstream change of the two liver in rats, which need we to research detailedly afterward.