European Surgical Research
Original Paper
A Novel End-to-Side Anastomosis Technique for Hepatic Rearterialization in Rat Orthotopic Liver Transplantation to Accommodate Size Mismatches between VesselsHuang H.a · Deng M.a · Jin H.a · Liu A.a, c · Dirsch O.b · Dahmen U.aaDepartment of General, Visceral and Transplantation Surgery, University Hospital Essen, Essen, and bDivision of Pathology, Deutsches Herzzentrum Berlin, Berlin, Germany; cCentre for Molecular Medicine, Shaoxing People’s Hospital, Shaoxing, PR China
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Article / Publication Details
Received: March 23, 2010
Accepted: February 07, 2011
Published online: June 01, 2011
Issue release date: August 2011
Number of Print Pages: 10
Number of Figures: 6
Number of Tables: 3
ISSN: 0014-312X (Print)
eISSN: 1421-9921 (Online)
For additional information: https://www.karger.com/ESR
Abstract
Background/Aims: We present our modification of a sutured arterial anastomosis in orthotopic rat liver transplantation as well as a literature survey and analysis of the existing techniques of rearterialization with regard to technical difficulties and potential limitations. Methods: The donor common hepatic artery (CHA) was anastomosed to the enlarged lumen of the recipient proper hepatic artery (PHA), tailored to match the size of the donor CHA, with an end-to-side interrupted suture technique. Vascular patency of hepatic rearterialization was assessed both intraoperatively and at the time the liver grafts were harvested (postoperative days 2 and 28). The effect of arterialization on hepatic morphology was confirmed by histological examination and compared to nonarterialized rat orthotopic liver transplantation. Results: The CHAs had a significantly larger diameter (up to 3-fold) compared to the PHAs, which represents a considerable size mismatch. The anastomosis procedure including the size adaptation required 15–25 min. All anastomoses were patent immediately, 5 min after rearterialization and at both harvest time points. The liver lobular architecture was intact in the rearterialized group, whereas a moderate degree of bile duct proliferation and portal/lobular lymphocytic infiltration were observed in the nonarterialized group. Conclusion: The new technique is a time-consuming and microsurgically challenging but universally applicable and robust procedure accommodating even a substantial mismatch in vessel diameter.
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Article / Publication Details
Received: March 23, 2010
Accepted: February 07, 2011
Published online: June 01, 2011
Issue release date: August 2011
Number of Print Pages: 10
Number of Figures: 6
Number of Tables: 3
ISSN: 0014-312X (Print)
eISSN: 1421-9921 (Online)
For additional information: https://www.karger.com/ESR
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