Artikel
Techniques of Liver Transplantation in the pig
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Veröffentlicht: | 23. April 2012 |
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Gliederung
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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.