A NEW MODEL OF LARGE-FOR-SIZE PORCINE LIVER TRANSPLANTATION WITH AORTIC CLAMPING

OBJECTIVE: The objective of the present study was to create a swine model of large-for-size liver transplantation, without venovenous bypass but clamping of the supraceliac aorta during the hepatic phase. MATERIAL AND METHODS: Fourteen Landrace-Large white pigs (weight 17 to 20 kg) were anesthetized with continuous infusion of propofol and fentanyl, and mechanically ventilated. They underwent orthotopic liver transplantation(OLT) with whole liver grafts and were divided randomly into two experimental groups, according to donor size. Regular size group (NS-n=7): donors weight were similar to the receptors (17–20 kg). Large-for-size group (LFS-n=7): donors weight was nearly two times the receptor ′ s (40–50 kg). Blood for serum levels of aspartate aminotransferase (AST) and hepatic tissue for histological examination and quantification of Bax (a proapoptotic protein) gene expression though real time PCR were sampled from the recipient at baseline, 1 and 3 h after portal reperfusion. RESULTS: In NS group, one death was related to hemodynamic instability just after aortic release and another due to bleeding by laceration on graft surface. In LFS 1,3 group, the two deaths were associated to hemodynamic instability just after aortic release. Table 1 shows the changes in AST levels over the experiment in both groups. Table 2 presents the histological results. Table 3 shows the results of Bax gene expression for the NS and LFS groups. CONCLUSION: This large-animal model is straightforward, reproducible, and clinically relevant. It provides the appropriate size and anatomy that resemble humans for the development and practice of new surgical techniques.