Significance of Hepatic Arterial Reconstruction on Model of Small-for-Size Orthotopic Liver Transplantation in Rats_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

XU Guiyun ¹ , JIANG Yi ² , CHEN Haiyan ³ , PAN Fan ²

1.Department of General Surgery, The Second People’s Hospital of Huai’an City, Huai’an 223002, Jiangsu Province, China;;
2.Hepatobiliary Surgery Institute of Nanjing Military Command, Fuzhou General Hospital, Organ Transplantation Institute of PLA, Fuzhou 350025, China;;
3.Department of Clinical Laboratory, The Second People’s Hospital of Huai’an City, Huai’an 223002, Jiangsu Province, ChinaCorresponding Author: JIANG Yi, E-mail: jiangyi183@yahoo.com.cn;

Corresponding author：

Keywords：

Small-for-size liver transplantation; Liver transplantation model; Hepatic artery reconstruction; Liver graft

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Objective 　To investigate the significance of hepatic arterial reconstruction on the model of 40% small-for-size orthotopic liver transplantation in rats.
Methods 　Modified two-cuff technique was applied to establish a rat model of 40% orthotopic liver transplantation. A total of 240 Sprague Dawley (SD) rats were randomly divided into 2 groups: reconstructive artery group and non-reconstructive artery group. One week survival rate was observed. Main indexes of liver function, histology and the expression of proliferative cell nuclear antigen (PCNA) of liver graft （by immunohistochemical method） were detected on day 1, 2, 4 and 7 after transplantation, respectively.
Results 　One week survival rates of reconstructive artery group and non-reconstructive artery group were 65.0% (13/20) and 50.0% (10/20) respectively (P gt;0.05). Alanine aminotransferase (ALT) and total bilirubin (TB) began to elevate from day 1 and peaked on day 2 after surgery in two groups. ALT in non-reconstructive artery group on day 2 and 4 were significantly higher than that in reconstructive artery group (P＜0.05). TB in non-reconstructive artery group on day 2 and 7 were significantly higher than that in reconstructive artery group (P＜0.05). Histological findings indicated that more diploid and polyploid hepatocytes and more gently dilation of central veins and hepatic sinusoids could be seen postoperatively in reconstructive artery group. The expression of PCNA of liver graft peaked on day 2 after surgery. The expression of PCNA of reconstructive artery group was higher on day 1 (P＜0.01) and lower on day 7 than that of non-reconstructive artery group after operation (P＜0.05).　
Conclusions 　Arterial reconstruction can improve liver function of liver grafts after small-for-size orthotopic liver transplantation, alleviate the histological changes and promote the regeneration of liver grafts quickly.

Citation： XU Guiyun,JIANG Yi,CHEN Haiyan,PAN Fan. Significance of Hepatic Arterial Reconstruction on Model of Small-for-Size Orthotopic Liver Transplantation in Rats. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2009, 16(9): 718-722. doi: Copy

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2.	Lo CM, Fan ST, Liu CL, et al. Imum graft size for successful living donor liver transplantation [Ｊ]. Transplantation, 1999; 68(8): 1112-1116.
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11.	Xu HS, Pruett TL, Jones RS. Study of donor-recipient liver size match for transplantation [Ｊ]. Ann Surg, 1994; 219(1): 46-50.
12.	Man K, Fan ST, Lo CM, et al. Graft injury in relation to graft size in right lobe live donor liver transplantation: a study of hepatic sinusoidal injury in correlation with portal hemodynamics and intragraft gene expression [Ｊ]. Ann Surg, 2003; 237(2): 256-264.
13.	Miki C, Iriyama K, Strain A, et al.Clinical significance of serum hepatocyte growth factor in orthotopic liver transplantation [Ｊ]. Surgery, 1996; 119(5): 505-510.
14.	Galand P, Degraef C. Cyclin/PCNA immunostaining as an al-ternative to tritiated thymidine pulse labelling for marking S phase cells in paraffin sections from animal and human tissues [Ｊ]. Cell Tissue Kinet, 1989; 22(5): 383-392.
15.	Fausto N. Liver regeneration [Ｊ]. J Hepatol, 2000; 32(1 Suppl): 19-31.

1. Heaton N. Small-for-size liver syndrome after auxiliary and split liver transplantation: donor selection [Ｊ]. Liver Transpl, 2003; 9(9): S26-S28.
2. Lo CM, Fan ST, Liu CL, et al. Imum graft size for successful living donor liver transplantation [Ｊ]. Transplantation, 1999; 68(8): 1112-1116.
3. 徐贵云，江艺，陈海燕，等. 大鼠40%小体积肝移植模型建立及移植肝的病理观察 [Ｊ]. 肝胆外科杂志, 2008; 16(6): 454-457.
4. Kamada N, Calne RY. Orthotopic liver transplantation in the rat. Technique using cuff for portal vein anastomosis and biliary drainage [Ｊ]. Transplantation, 1979; 28(1): 47-50.
5. 徐贵云，江艺，陈海燕，等. 大鼠40%小体积肝移植动脉化模型建立及移植肝的病理观察 [Ｊ]. 中国普外基础与临床杂志， 2009; 16(3): 180-183.
6. Knoop M, Bachmann S, Keck H, et al. Experience with cuff rearterialization in 600 orthotopic liver grafts in the rat [Ｊ]. Am J Surg, 1994; 167(3): 360-363.
7. Li J, Dahmen U, Dirsch O, et al. Modified sleeve anastomosis for reconstruction of the hepatic artery in rat liver transplantation [Ｊ]. Microsurgery, 2002; 22(2): 62-68.
8. 黄新立, 张峰, 王学浩, 等. 建立大鼠部分肝移植动脉化模型的实验研究 [Ｊ]. 中国普外基础与临床杂志, 2004; 11(3)： 224-227.
9. Gao W, Lemasters JJ, Thurman RG. Development of a new method for hepatic rearterialization in rat orthotopic liver transplantation. Reduction of liver injury and improvement of surgical outcome by arterialization [Ｊ]. Transplantation,1993; 56(1): 19-24.
10. Reck T, Steinbauer F, Steinbauer M, et al. Impact of arterialization on hepatic oxygen supply, tissue energy phosphates, and outcome after liver transplantation in the rat [Ｊ]. Transplantation, 1996; 62(5): 582-587.
11. Xu HS, Pruett TL, Jones RS. Study of donor-recipient liver size match for transplantation [Ｊ]. Ann Surg, 1994; 219(1): 46-50.
12. Man K, Fan ST, Lo CM, et al. Graft injury in relation to graft size in right lobe live donor liver transplantation: a study of hepatic sinusoidal injury in correlation with portal hemodynamics and intragraft gene expression [Ｊ]. Ann Surg, 2003; 237(2): 256-264.
13. Miki C, Iriyama K, Strain A, et al.Clinical significance of serum hepatocyte growth factor in orthotopic liver transplantation [Ｊ]. Surgery, 1996; 119(5): 505-510.
14. Galand P, Degraef C. Cyclin/PCNA immunostaining as an al-ternative to tritiated thymidine pulse labelling for marking S phase cells in paraffin sections from animal and human tissues [Ｊ]. Cell Tissue Kinet, 1989; 22(5): 383-392.
15. Fausto N. Liver regeneration [Ｊ]. J Hepatol, 2000; 32(1 Suppl): 19-31.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Significance of Hepatic Arterial Reconstruction on Model of Small-for-Size Orthotopic Liver Transplantation in Rats

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