Improved donor liver position selection and revascularization for heterotopic auxiliary liver transplantation with portal vein arterialization

Purpose: To establish an animal model of improved donor liver position selection and revascularization for heterotopic auxiliary liver transplantation with portal vein arterialization (HALT-PVA). Methods: Sprague-Dawley rats were utilized to establish models. Improved HALT-PVA was conducted for the experimental rat: hepatic common artery of donor liver was end-to-side anastomosed to portal vein which was end-to-side anastomosed to the left common iliac artery of host rat, while the segments of inferior vena cava superior and inferior to the donor liver were end-to-side anastomosed to the inferior vena cava of host rat, respectively. For the control rats, liver transplantations were conducted through end-to-end anastomosis between portal vein of donor liver and stand tube placed in right renal artery of host rat, and end-to-side anastomosis between the inferior vena cava inferior to the donor liver with the inferior vena cava of host rat, while the inferior vena cava superior to the donor liver was stitched up. Besides, hepaticoenterostomy were performed to all rats and survival status were monitored. ALT, AST, TBil and CHE were tested continuously after operation, and pathological examination of liver tissues were performed. Results: The survival rate was 93.3% (14/15). ALT, AST, TBil and CHE for experimental group showed a rapider recovery of liver functions than controls. Pathological examinations of liver tissues from the experimental-group rats showed better presentation than the control-group rats. Conclusions: The improved HALT-PVA better accords with the normal anatomy, with little detriment to implanted liver, and therefore is a good model for HALT-PVA related research.