gms | German Medical Science

129. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

24.04. - 27.04.2012, Berlin

Techniques of Liver Transplantation in the pig

Meeting Abstract

  • Arash Nickkholgh - UniversitätsKlinikum Heidelberg, Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Heidelberg
  • Majid EsmaEilzadeh Moghaddam - UniversitätsKlinikum Heidelberg, Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Heidelberg
  • Hamidreza Fonouni - UniversitätsKlinikum Heidelberg, Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Heidelberg
  • Mohammad Golriz - UniversitätsKlinikum Heidelberg, Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Heidelberg
  • Morva Tahmasbi Rad - UniversitätsKlinikum Heidelberg, Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Heidelberg
  • Nuh N. Rahbari - UniversitätsKlinikum Heidelberg, Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Heidelberg
  • Jan Schmidt - UniversitätsKlinikum Heidelberg, Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Heidelberg
  • Arianeb Mehrabi - UniversitätsKlinikum Heidelberg, Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Heidelberg

Deutsche Gesellschaft für Chirurgie. 129. Kongress der Deutschen Gesellschaft für Chirurgie. Berlin, 24.-27.04.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. Doc12dgch155

doi: 10.3205/12dgch155, urn:nbn:de:0183-12dgch1559

Published: April 23, 2012

© 2012 Nickkholgh et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Background: From the beginning of liver transplantation (LTx) in humans, experimental research in animals has been associated with clinical practice. Results obtained in these experiments have been used in clinical setting and if the clinicians encountered problems, these were referred again to animal practice to be answered clearly. Our aim is to review the various techniques of porcine LTx, its pitfalls and complications.

Materials and methods: A review of the literature focusing on LTx in porcine models showed that different methods or modifications have been described. Each modification is the result of a change or simplification of the five main reconstructions: the suprahepaticinferior vena cava (SHVC), infrahepatic inferior vena cava (IHVC), portal vein (PV), hepatic artery (HA), and bile duct (BD).

Results: Method of choice for SHVC and IHVC is end to end anastomosis due to shorter time and lower risk. A prosthesis is used in case of a side to side anastomosis, the so-calledmodified piggyback technique. The PV anastomoses are performed in an end to end fashion between donor and recipient PV, cuff method or stump method. Simplicity of carrel patch was the reason to use it in liver arterilization. Additionally, donor HA anastomosis is preferable in an end to end fashion to prevent damage to lymph vessels. There are three major methods for reconstruction of BD: end to end or side to side choledochocholedochostomy, and choledojejunostomy with Roux-en Y jejunal loop that used for a small duct.

Conclusion: Every method has his advantages and disadvantages that depends on the aim ofthe study. Therefore, the most physiologic techniques for anastomoses must be preferred for long-term survival studies, while the faster techniques are options for short-term survival studies.