Modifications in combined liver-small bowel transplantation in pigs.

AIM: To introduce combined liver-small bowel transplantation in pigs.

METHODS

Eighteen transplantations in 36 large white pigs were performed. Three modifications in combined liver-small bowel transplantation model were applied: Veno-venous bypass was not used. Preservation of the donor duodenum and head of pancreas in continuity with the combined graft to avoid biliary reconstruction. The splenic vein of donor was anastomosed end-to-end with the portal vein of recipients by the formation of a "cuff".

RESULTS

Without immunosuppressive therapy, 72-hour survival rate of the transplanted animals was 72 % (13/18). Five of 18 pigs operated died of respiratory failure (3 cases) and bleeding during hepatectomy (2 cases). The longest survival time of animals was 6 days.

CONCLUSION

Our surgical modifications are feasible and reliable, which have made the transplantation in pigs simpler and less aggressive, and thus these can be used for preclinical study.