The Study on Establishment of Liver Transplantation Model by Using Marginal Size Liver Graft in Rat_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LU Jingning ¹ ,  PENG Minhao ¹ , YANG Hong ² , XIAO Kaiyin ¹ , CHEN Bin. ¹

1.Department of Hepatobiliary Surgery， The First Affiliated Hospital of Guangxi Medical University， Nanning 530021， Guangxi Zhuang Autonomous Region， China;;
2.Department of Ultrasound， The First Affiliated Hospital of Guangxi Medical University， Nanning 530021， Guangxi ZhuangAutonomous Region， China;

Corresponding author：

PENG Minhao, Email: minhaopeng@163.com

Keywords：

Liver transplantation; Marginal size liver graft; Small-for-size syndrome; Rat

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Objective 　To establish different kinds of reduced size liver transplantation model of rats， and to explore
the optimal marginal size of liver graft in orthotopic liver transplantation， in purpose of providing a kind of animal model
for the study about mechanism and prevention measures of small-for-size syndrome.
Methods 　One hundred and ninety-two rats were randomly divided into whole liver graft transplantation group （underwent whole liver graft transplantation），half liver graft transplantation group （the median lobe and right lobe of the liver were selected to be the graft）， small size liver graft transplantation group （the median lobe of the liver was selected to be the graft）， and extra-small size liver graft transplantation group （the median lobe and left lobe of the liver were reduced， and remained lobes were selected to be the graft）， each group enrolled 48 rats. After liver graft transplantation， 24 rats of each group were selected to observe the survival situation， 12 rats of each group were selected to measure portal venous pressure at time point of before operation，and 5， 15， 30， 45， and 60 minutes after transplantation. The other 12 rats of each group were test the level of alanine aminotransferase （ALT）.
Results 　Seven-day survival rate of the whole liver graft transplantation group， half liver graft transplantation group， small size liver graft transplantation group， and extra-small size liver graft transplantation group was 100% （24/24）， 87.5% （21/24）， 37.5% （9/24）， and 0 respectively. Portal venous pressure of whole liver graft trans-plantation group was stable after opening the portal vein， although there was slight increase at prophase in half liver graft transplantation group， and then the portal venous pressure would let down， keeping stable at the later stage. But in small size liver graft transplantation group and extra-small size liver graft transplantation group， the portal venous pressure incr-eased and got the top at 15 minutes after opening the portal vein， and then induced， keeping stable during the 45-60 minutes.Portal venous pressure at the point of 5 （r=-0.942）， 15 （r=-0.947）， 30 （r=-0.900）， 45 （r=-0.825）， and 60 （r=-0.705）
minutes after opening the portal vein were significantly related to liver graft size （P＜0.001）. The levels of ALT in whole
liver graft transplantation group and half liver graft transplantation group were both lower than those of small size liver
graft transplantation group and extra-small size liver graft transplantation group （P＜0.05）， and levels of ALT in small size liver graft transplantation group was lower than extra-small size liver graft transplantation group too （P＜0.05）. Level
of ALT at 24 hours after transplantation were significantly related to liver graft size （r=-0.685， P＜0.001）.
Conclusions 　The minimum graft volume/standard liver volume （GV/SLV） in reduced size liver transplantation in rat is 50%. The liver graft whose GV/SLV is 30%-35% should be considered as marginal size liver graft， and the liver graft whose GV/SLV less than 30% should be considered as extra-small size liver graft in the rat.

Citation： LU Jingning,PENG Minhao,YANG Hong,XIAO Kaiyin,CHEN Bin.. The Study on Establishment of Liver Transplantation Model by Using Marginal Size Liver Graft in Rat. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2013, 20(12): 1352-1357. doi: Copy

1.	Miyagi S， Kawagishi N， Fujimori K， et al. Risks of donation and quality of donors’ life after living donor liver transplantation[J]. Transpl Int， 2005， 18(1)：47-51.
2.	Ghobrial RM， Freise CE， Trotter JF， et al. Donor morbidity after living donation for liver transplantation[J]. Gastroenterology，2008， 135(2)：468-476.
3.	Kousoulas L， Becker T， Richter N， et al. Living donor liver transplantation：effect of the type of liver graft donation on donor mortality and morbidity[J]. Transpl Int， 2011， 24(3)：251-258.
4.	Campos BD， Botha JF. Strategies to optimize donor safety with smaller grafts for adult-to-adult living donor liver transplantation[J]. Curr Opin Organ Transplant， 2012， 17(3)：230-234.
5.	Lei JY， Wang WT， Yan LN. Risk factors of SFSS in adult-to-adultliving donor liver transplantation using the right liver：a single-center analysis of 217 cases[J]. Hepatogastroenterology， 2012， 59 (117)：1491-1497.
6.	Yagi S， Uemoto S. Small-for-size syndrome in living donor liver transplantation[J]. Hepatobiliary Pancreat Dis Int， 2012， 11(6)：570-576.
7.	陆森，钱建民，黄海清，等. 几种不同预测大鼠肝脏体积(重量)方法的比较[J]. 中华实验外科杂志， 2002， 19(3)：252-253.
8.	Kamada N， Calne RY. Orthotopic liver transplantation in the rat. Technique using cuff for portal vein anastomosis and biliary drainage[J]. Transplantation， 1979， 28(1)：47-50.
9.	Kobayashi E， Kamada N， Goto S， et al. Protocol for the techniqueof orthotopic liver transplantation in the rat[J]. Microsurgery， 1993， 14(8)：541-546.
10.	卢景宁，彭民浩，杨定华. 直视下建立大鼠全血供原位肝移植模型[J]. 广西医科大学学报， 2007， 24(4)：548-549.
11.	沈浩元，王炜，刘猛，等. 改良单人操作大鼠原位肝移植模型的建立[J]. 中国普外基础与临床杂志， 2011， 18(8)：825-828.
12.	Selvaggi G， Tzakis A. Surgical considerations in liver transplantation：small for size syndrome[J]. Panminerva Med， 2009， 51(4)：227-233.
13.	Gonzalez HD， Liu ZW， Cashman S， et al. Small for size syndromefollowing living donor and split liver transplantation[J]. World J Gastrointest Surg， 2010， 2(12)：389-394.
14.	Gruttadauria S， Pagano D， Luca A， et al. Small-for-size syndromein adult-to-adult living-related liver transplantation[J]. World J Gastroenterol， 2010， 16(40)：5011-5015.
15.	Chen Z， Yan L， Li B， et al. Prevent small-for-size syndrome using dual grafts in living donor liver transplantation[J]. J Surg Res， 2009， 155(2)：261-267.
16.	Liu C， Lee RC， Loong CC， et al. Increasing donor body weight to prevent small-for-size syndrome in living donor liver transplantation[J]. World J Surg， 2010， 34(10)：2401-2408.
17.	Oniscu GC， Wigmore SJ. Increasing donor body weight to prevent small-for-size syndrome in living donor liver transplantation[J]. World J Surg， 2010， 34(10)：2409-2410.
18.	Tamura S， Sugawara Y， Kokudo N. Should we promote “incre-asing donor body weight to prevent small-for-size syndrome in living donor liver transplantation”?[J]. World J Surg， 2011， 35(10)：2356-2357.
19.	Attia M， Silva MA， Mirza DF. The marginal liver donor—an update[J]. Transpl Int， 2008， 21(8)：713-724.
20.	蓝翔，李波，王小飞，等. 活体肝移植中非标准供肝的可用性分析[J]. 中华肝脏病杂志， 2009， 17(2)：124-127.
21.	Kiuchi T， Kasahara M， Uryuhara K， et al. Impact of graft size mismatching on graft prognosis in liver transplantation from living donors[J]. Transplantation， 1999， 67(2)：321-327.
22.	Lo CM， Fan ST， Liu CL， et al. Minimum graft size for successfulliving donor liver transplantation[J]. Transplantation， 1999， 68(8)：1112-1116.
23.	Lee SG. Living-donor liver transplantation in adults[J]. Br Med Bull， 2010， 94：33-48.
24.	Man K， Lo CM， Ng IO， et al. Liver transplantation in rats using small-for-size grafts：a study of hemodynamic and morphological changes[J]. Arch Surg， 2001， 136(3)：280-285.
25.	Li J， Liang L， Ma T， et al. Sinusoidal microcirculatory changes after small-for-size liver transplantation in rats[J]．Transpl Int， 2010， 23(9)：924-933.

1. Miyagi S， Kawagishi N， Fujimori K， et al. Risks of donation and quality of donors’ life after living donor liver transplantation[J]. Transpl Int， 2005， 18(1)：47-51.
2. Ghobrial RM， Freise CE， Trotter JF， et al. Donor morbidity after living donation for liver transplantation[J]. Gastroenterology，2008， 135(2)：468-476.
3. Kousoulas L， Becker T， Richter N， et al. Living donor liver transplantation：effect of the type of liver graft donation on donor mortality and morbidity[J]. Transpl Int， 2011， 24(3)：251-258.
4. Campos BD， Botha JF. Strategies to optimize donor safety with smaller grafts for adult-to-adult living donor liver transplantation[J]. Curr Opin Organ Transplant， 2012， 17(3)：230-234.
5. Lei JY， Wang WT， Yan LN. Risk factors of SFSS in adult-to-adultliving donor liver transplantation using the right liver：a single-center analysis of 217 cases[J]. Hepatogastroenterology， 2012， 59 (117)：1491-1497.
6. Yagi S， Uemoto S. Small-for-size syndrome in living donor liver transplantation[J]. Hepatobiliary Pancreat Dis Int， 2012， 11(6)：570-576.
7. 陆森，钱建民，黄海清，等. 几种不同预测大鼠肝脏体积(重量)方法的比较[J]. 中华实验外科杂志， 2002， 19(3)：252-253.
8. Kamada N， Calne RY. Orthotopic liver transplantation in the rat. Technique using cuff for portal vein anastomosis and biliary drainage[J]. Transplantation， 1979， 28(1)：47-50.
9. Kobayashi E， Kamada N， Goto S， et al. Protocol for the techniqueof orthotopic liver transplantation in the rat[J]. Microsurgery， 1993， 14(8)：541-546.
10. 卢景宁，彭民浩，杨定华. 直视下建立大鼠全血供原位肝移植模型[J]. 广西医科大学学报， 2007， 24(4)：548-549.
11. 沈浩元，王炜，刘猛，等. 改良单人操作大鼠原位肝移植模型的建立[J]. 中国普外基础与临床杂志， 2011， 18(8)：825-828.
12. Selvaggi G， Tzakis A. Surgical considerations in liver transplantation：small for size syndrome[J]. Panminerva Med， 2009， 51(4)：227-233.
13. Gonzalez HD， Liu ZW， Cashman S， et al. Small for size syndromefollowing living donor and split liver transplantation[J]. World J Gastrointest Surg， 2010， 2(12)：389-394.
14. Gruttadauria S， Pagano D， Luca A， et al. Small-for-size syndromein adult-to-adult living-related liver transplantation[J]. World J Gastroenterol， 2010， 16(40)：5011-5015.
15. Chen Z， Yan L， Li B， et al. Prevent small-for-size syndrome using dual grafts in living donor liver transplantation[J]. J Surg Res， 2009， 155(2)：261-267.
16. Liu C， Lee RC， Loong CC， et al. Increasing donor body weight to prevent small-for-size syndrome in living donor liver transplantation[J]. World J Surg， 2010， 34(10)：2401-2408.
17. Oniscu GC， Wigmore SJ. Increasing donor body weight to prevent small-for-size syndrome in living donor liver transplantation[J]. World J Surg， 2010， 34(10)：2409-2410.
18. Tamura S， Sugawara Y， Kokudo N. Should we promote “incre-asing donor body weight to prevent small-for-size syndrome in living donor liver transplantation”?[J]. World J Surg， 2011， 35(10)：2356-2357.
19. Attia M， Silva MA， Mirza DF. The marginal liver donor—an update[J]. Transpl Int， 2008， 21(8)：713-724.
20. 蓝翔，李波，王小飞，等. 活体肝移植中非标准供肝的可用性分析[J]. 中华肝脏病杂志， 2009， 17(2)：124-127.
21. Kiuchi T， Kasahara M， Uryuhara K， et al. Impact of graft size mismatching on graft prognosis in liver transplantation from living donors[J]. Transplantation， 1999， 67(2)：321-327.
22. Lo CM， Fan ST， Liu CL， et al. Minimum graft size for successfulliving donor liver transplantation[J]. Transplantation， 1999， 68(8)：1112-1116.
23. Lee SG. Living-donor liver transplantation in adults[J]. Br Med Bull， 2010， 94：33-48.
24. Man K， Lo CM， Ng IO， et al. Liver transplantation in rats using small-for-size grafts：a study of hemodynamic and morphological changes[J]. Arch Surg， 2001， 136(3)：280-285.
25. Li J， Liang L， Ma T， et al. Sinusoidal microcirculatory changes after small-for-size liver transplantation in rats[J]．Transpl Int， 2010， 23(9)：924-933.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

The Study on Establishment of Liver Transplantation Model by Using Marginal Size Liver Graft in Rat

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