Hao Jie, Yu Jia-Wei, Xiao Jing-Wen, Xiang Lin-Biao, Peng Rong, Quan Jia-Qi, Dong Ya-Xu, Li En-Hui, Wang Juan-Juan, Ren Lu, Wan Yong, Zhang Hong-Ke, Lv Yi, Lu Qiang
National Local Joint Engineering Research Center for Precision Surgery and Regenerative Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Surg Open Sci. 2024 Oct 29;22:34-39. doi: 10.1016/j.sopen.2024.10.006. eCollection 2024 Dec.
The current method for liver graft implantation during the anhepatic phase is complex. Therefore, this study aimed to introduce a modified orthotopic liver transplantation (OLT) technique with major vascular reconstruction using cuff technique to simplify the process of liver graft implantation during the anhepatic phase.
Twenty-four canines were randomly assigned to two groups: the modified orthotopic liver transplantation group (M-OLT, = 12) and the control group (n = 12). All animals were randomly assigned to the donor or recipient groups. The recipients received orthotopic liver transplantation using a modified technique in the M-OLT group, and OLT using traditional implantation technique without venovenous bypass was performed in the control group. The donor and recipient characteristics were compared between the two groups. Vascular anastomotic patency was evaluated using angiography immediately and one week after surgery.
All recipients underwent successful liver transplantation. There were no significant differences between the two groups in terms of sex, body weight, or cold ischemia time of the donor liver. However, recipients in the M-OLT group had a shorter operation time, less intraoperative blood loss, shorter anhepatic phase, shorter vascular occlusion time, and shorter warm ischemia time than that in the control group (all < 0.05). No anastomotic leakage or stenosis was detected in either group after liver transplantation. One recipient in the M-OLT group and three in the control group died within one week of transplantation.
This modified technique is safe and feasible for canine liver transplantation and can significantly simplify liver graft implantation procedures during the anhepatic period.
目前在无肝期进行肝移植植入的方法较为复杂。因此，本研究旨在引入一种改良的原位肝移植（OLT）技术，采用袖套技术进行主要血管重建，以简化无肝期肝移植植入过程。
将24只犬随机分为两组：改良原位肝移植组（M-OLT，n = 12）和对照组（n = 12）。所有动物随机分为供体组或受体组。M-OLT组的受体采用改良技术接受原位肝移植，对照组采用无静脉-静脉转流的传统植入技术进行OLT。比较两组供体和受体的特征。术后立即和术后1周通过血管造影评估血管吻合通畅情况。
所有受体均成功进行了肝移植。两组在性别、体重或供肝冷缺血时间方面无显著差异。然而，M-OLT组的受体手术时间更短、术中出血量更少、无肝期更短、血管阻断时间更短、热缺血时间比对照组更短（均P < 0.05）。肝移植后两组均未检测到吻合口漏或狭窄。M-OLT组1只受体和对照组3只受体在移植后1周内死亡。
这种改良技术用于犬肝移植是安全可行的，并且可以显著简化无肝期肝移植植入程序。
