Establishment of splenic fossa auxiliary partial heterotopic living donor liver transplantation models in miniature pigs

Objective This study was performed to develop a clinically relevant porcine model of auxiliary partial heterotopic living donor liver transplantation in splenic fossa. Methods Twenty female Guangxi Bama miniature pigs with similar body weight were randomly divided into donor group (n=10) and recipient group (n=10). The left hemi hepatic graft without middle hepatic vein was procured from the living donor under the general anesthesia. The liver graft was tailored at the back table; an 8-mm diameter polytetrafluoroethylene graft about 2.5 cm long was connected to the left hepatic vein. The liver graft was implanted in the splenic fossa after splenectomy and left nephrectomy, with a hepatorenal venous anastomosis (via artificial graft), splenpotal venous anastomosis, and splenohepatic arterial anastomosis in end-to-end fashion, respectively. A polyethylene tube was inserted into the left bile duct branch of the graft and led through the body wall as an external biliary drain. No immunosuppressive drugs were given in this series. Survival rate and complications were observed with 2 weeks after transplantation. Results Ten pig models of auxiliary partial heterotopic living donor liver transplantation were successfully established. Two-week survival rates were 70% and 60% for donors and recipients, respectively. But only three recipients had well-functioning graft livers. Conclusion Despite a high morbidity rates including hepatic artery thrombosis, portal vein thrombosis and artificial graft mural thrombus formation, it is feasible to use left hemi hepatic graft without middle hepatic vein from living donor and splenic fossa auxiliary partial heterotopic liver transplantation in miniature pig. Key words: Liver Transplantation; Pigs; Animal models; Living donors; Heterotopic; Polytetrafluoroethylene