A Rat Model of Orthotopic Liver Transplantation Using a Novel Magnetic Anastomosis Technique for Suprahepatic Vena Cava Reconstruction

Lifei Yang; Jianwen Lu; Yue Wang; Mei Zhang; Yuan Shi; Shasha Wei; Peng Liu; Zheng Wu; Yi Lv; Rongqian Wu

doi:10.3791/56933

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Method Article

A Rat Model of Orthotopic Liver Transplantation Using a Novel Magnetic Anastomosis Technique for Suprahepatic Vena Cava Reconstruction

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DOI:

10.3791/56933

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March 19th, 2018

Lifei Yang^*¹^,² , Jianwen Lu^*¹^,²^,³ , Yue Wang¹^,²^,³ , Mei Zhang¹^,²^,³ , Yuan Shi⁴ , Shasha Wei¹^,² , Peng Liu¹^,²^,³ , Zheng Wu³ , Yi Lv¹^,²^,³ , Rongqian Wu¹^,²

¹Shaanxi Provincial Center for Regenerative Medicine and Surgical Engineering, First Affiliated Hospital, Xi'an Jiaotong University, ²Institute of Advanced Surgical Technology and Engineering, First Affiliated Hospital, Xi'an Jiaotong University, ³Department of Hepatobiliary Surgery, First Affiliated Hospital, Xi'an Jiaotong University, ⁴Organ Transplantation Center, Tianjin First Center Hospital

^* These authors contributed equally

Summary

The reconstruction of the suprahepatic vena cava (SHVC) remains a difficult step in rat orthotopic liver transplantation. In this article, we show a step-by-step protocol for SHVC reconstruction in rats using a novel magnetic anastomosis technique.

Abstract

The rat model of orthotopic liver transplantation (OLT) is essential for transplant research. It is a very sophisticated animal model and requires a steep learning curve. The introduction of the cuff technique for anastomosis of the portal vein (PV) and infrahepatic vena cava (IHVC) has significantly simplified the transplant procedure in rats. However, due to the short anterior wall of the recipients' suprahepatic vena cava (SHVC), the cuff technique is very difficult to use for the reconstruction of the SHVC. Most researchers in this field still use the hand-suture technique for SHVC reconstruction, which makes it the bottleneck step in rat orthotopic liver transplantation. The magnetic anastomosis technique (i.e., magnamosis) is a method of connecting two vessels using the attractive force between two magnets. Our recent study has shown that the magnetic anastomosis technique is superior to the hand-suture technique for SHVC reconstruction in rats. In this article, we show a step-by-step protocol for SHVC reconstruction in rats using the novel magnetic anastomosis technique. In this model, the reconstruction of the PV and IHVC was performed by the standard cuff technique, while the reconstruction of the bile duct (BD) was performed by a stent technique. The hepatic re-arterialization was not performed. The magnetic anastomosis technique made SHVC reconstruction much easier and significantly shortened the anphepatic phase. After a reasonable learning curve, even researchers without advanced microsurgical skills can produce reliable and reproducible results using this rat model of OLT.

Introduction

The rat model of orthotopic liver transplantation (OLT) is essential for transplant research¹^,². The first rat OLT was described by Lee et al. in 1973³. In that model, all the vessels were reconstructed by the hand-suture technique. The hand-suture technique requires advanced microsurgical skills, which significantly limits its utilization. Since then, various modifications to the original protocol of rat OLT have been reported. Among them, the cuff technique for anastomosis of the portal vein (PV) and infrahepatic vena cava (IHVC) reported by Kamada et al. in 1979 is ....