Liver Transplantation

Abstract

Today orthotopic rat liver transplantation (ORLT) is an established model for immunological studies after liver transplantation and for the study of organ preservation and graft metabolism. Since 1973 when Lee et al. [10] first described the technique it has been modified by many groups. Today two techniques must be distinguished: a nonarterialized transplantation technique without reestablishment of the arterial blood supply, and the physiological, arterialized transplantation model. The arterialized technique, originally described by Lee et al. [11], has been modified and standardized by Engemann [2]. The nonarterialized technique has been simplified by Kamada and Calne [8] by replacing a conventional suture technique by the use of polyethylene cuffs for the anastomoses of the portal vein and the intrahepatic inferior vena cava. Both the arterialized and the nonarterialized technique result in satisfactory long-term survival rates in the rat. However, only the physiological arterialized technique results in a preserved histological appearance of the liver graft [1]. Thus, the necessity of rearterialization of a rat liver graft is now almost generally accepted. Hence many groups have focused their research on variations of the arterial anastomosis technique, for example, the use of a cuff technique with anastomosis of the proper hepatic artery to the recipient’s common hepatic artery [15] and a stent technique with direct proper hepatic artery anastomosis [3].