Analysis of The Death Causes of Postoperative Early-Stage after Orthotopic Liver Transplantation in Rats and Their Solution Strategies_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 LIUJian ¹ ,  LILi ¹ , ZHANGSheng-ning ¹ , LILai-bang ¹ , WANGXiao-chuan ²

1. Department of Hepatobiliary Surgery, The First People's Hospital of Kunming, Kunming 650011, Yunnan Province, China;
2. Department of Dermatology, The First People's Hospital of Yunnan Province, Kunming 650032, Yunnan Province, China;

Corresponding?author：

LILi, Email: Ynkmlilli62@hotmail.com

Keywords：

Orthotopic liver transplantation; Postoperative early-stage death; Solution strategy; Rat

DOI：

10.7507/1007-9424.20140360

Video：

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Objective To analyze the death causes of postoperative early-stage after orthotopic liver transplantation (OLT) in rats, and to provide appropriate treatment strategies. Methods Three hundreds of rat OLT models were performed by modified Kamada two-cuff technique. Operation time of each stage during OLT and postoperative survival time of rats were recorded and analyzed. According to survival time, the rats were divide into 4 groups:intraoperative death group (rats died during operation), < 6 hours group, 6-24 hours group, and > 24 hours group. Then comparison of operation time of each stage during OLT in rats of 4 groups was performed, and reasons of death during 24 hours after OLT were analyzed. Results Of the 300 OLT models, 37 rats died during operation (12.33%), 51 rats died within 6 hours after operation (17.00%), 76 rats died during 6-24 hours after operation (25.33%), and 136 rats survived longer than 24 hours (45.34%). The most common death causes of < 6 hours group were as follows:lose too much blood during the operation (27.45%, 14/51), postoperative bleeding (27.45%, 14/51), and vascular embolization (15.69%, 8/51). However, the most common death causes of 6-24 hours group were as follows:angiostenosis (27.63%, 21/76), postoperative bleeding (21.05%, 16/76), and pulmonary edema (19.74%, 15/76). There were significant differences in the cold ischemia time and anhepatic phase among the 4 groups (P < 0.05). The cold ischemia time and anhepatic phase of intraoperative death group were longer than those of other 3 groups (P < 0.05), in addition, the cold ischemia time of > 24 hours group was shorter than those of other 3 groups (P < 0.05). Conclusions There are many reasons leading to the early death after OLT. The long time of anhepatic phase and the cold ischemia time, intraoperative and postoperative bleeding, thrombosis, angiostenosis, and pulmonary edema are key factors for the improvement of prognosis in rats after OLT operation. Improvements of the reasons above are helpful to improve the successful rate of modeling and quality of OLT rats.

Citation： LIUJian, LILi, ZHANGSheng-ning, LILai-bang, WANGXiao-chuan. Analysis of The Death Causes of Postoperative Early-Stage after Orthotopic Liver Transplantation in Rats and Their Solution Strategies. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(12): 1524-1530. doi: 10.7507/1007-9424.20140360 Copy

1.	Oldani G, Lacotte S, Morel P, et al.Orthotopic liver transplantation in rats[J].J Vis Exp, 2012, (65):4143.
2.	徐平.實驗動物管理與使用操作技術規程[M].上海:上海科學技術出版社, 2007:5-20.
3.	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.
4.	Lee S, Charters AC, Chandler JG, et al.A technique for orthotopic liver transplantation in the rat[J].Transplantation, 1973, 16(6):664-669.
5.	姚坤厚, 高毅, 潘明新, 等.大鼠原位肝移植急性排斥模型的建立[J].實用醫學雜志, 2008, 24(8):1304-1306.
6.	Tan F, Chen Z, Zhao Y, et al.Novel technique for suprahepatic vena cava reconstruction in rat orthotopic liver transplantation[J].Microsurgery, 2005, 25(7):556-560.
7.	劉靜, 孫爾維, 汪爽, 等."開放灌注四牽三縫二橫一拉"法行大鼠原位肝移植[J].中華器官移植雜志, 2005, 26(11):695-697.
8.	Miyata M, Fischer JH, Fuhs M, et al.A simple method for ortho-topic liver transplantation in the rat.Cuff technique for three vas-cular anastomoses[J].Transplantation, 1980, 30(5):335-338.
9.	Kashfi A, Mehrabi A, Pahlavan PS, et al.A review of various techniques of orthotopic liver transplantation in the rat[J].Tran-splant Proc, 2005, 37(1):185-188.
10.	張華, 楊定華, 彭民浩.改良"二袖套法"大鼠原位肝移植及早期并發癥預防[J].中國現代手術學雜志, 2007, 11(4):247-250.
11.	張國偉, 周杰, 趙宏峰, 等.改良Kamada法大鼠肝移植并發癥的常見因素及預防[J].中國臨床解剖學雜志, 2009, 27(3):363-365.
12.	馬毅, 何曉順, 陳規劃.大鼠原位肝移植模型的手術技巧及并發癥的預防[J].中華顯微外科雜志, 2003, 26(1):45-47.
13.	Matevossian E, Doll D, Hüser N, et al.Liver transplantation in the rat:single-center experience with technique, long-term survival, and functional and histologic findings[J].Transplant Proc, 2009, 41(6):2631-2636.
14.	Ariyakhagorn V, Schmitz V, Olschewski P, et al.Improvement of microsurgical techniques in orthotopic rat liver transplantation[J].J Surg Res, 2009, 153(2):332-339.
15.	Ma M, Ma ZH.Effect of tumor necrosis factor-alpha in rats with hepatic ischemia-reperfusion injury[J].Hepatobiliary Pancreat Dis Int, 2008, 7(3):296-299.
16.	Camacho VR, de Fraga RS, Cerski CT, et al.Relationship bet-ween ischemia/reperfusion injury and the stimulus of fibrogenesis in an experimental model:comparison among different preservation solutions[J].Transplant Proc, 2011, 43(10):3634-3637.
17.	Wang H, Li C, Hu J, et al.Effect of different suprahepatic vena cava reconstruction methods on the hemodynamics of rats after liver transplantation[J].PLoS One, 2013, 8(9):e72695.
18.	Aguirre-Avalos G, Covarrubias-Velasco MA, Rojas-Sánchez AG.Venous outflow obstruction and portopulmonary hypertension after orthotopic liver transplantation[J].Am J Case Rep, 2013, 14:354-358.
19.	De Gasperi A, Feltracco P, Ceravola E, et al.Pulmonary comp-lications in patients receiving a solid-organ transplant[J].Curr Opin Crit Care, 2014, 20(4):411-419.
20.	Feltracco P, Carollo C, Barbieri S, et al.Early respiratory comp-lications after liver transplantation[J].World J Gastroenterol, 2013, 19(48):9271-9281.
21.	劉靜, 李江, 張升寧, 等.大鼠減體積肝移植腹腔出血的原因分析[J].南方醫科大學學報, 2010, 30(5):1075-1078.
22.	Lausada NR, Gondolesi GE, Ortiz E, et al.Orthotopic liver transplant in rats.Surgical technique, complications and treatment[J].Acta Gastroenterol Latinoam, 2002, 32(2):63-70.
23.	Kobayashi E, Kamada N, Goto S, et al.Protocol for the technique of orthotopic liver transplantation in the rat[J].Microsurgery, 1993, 14(8):541-546.
24.	彭方興, 鄭本波, 劉立新, 等.大鼠原位肝移植動物模型制作要點[J].中國普外基礎與臨床雜志, 2005, 12(2):117-119.
25.	Mehrabi A, Fonouni H, Müller SA, et al.Current concepts in transplant surgery:liver transplantation today[J].Langenbecks Arch Surg, 2008, 393(3):245-260.
26.	Karp SJ, Johnson S, Evenson A, et al.Minimising cold isch-aemic time is essential in cardiac death donor-associated liver transplantation[J].HPB (Oxford), 2011, 13(6):411-416.

1. Oldani G, Lacotte S, Morel P, et al.Orthotopic liver transplantation in rats[J].J Vis Exp, 2012, (65):4143.
2. 徐平.實驗動物管理與使用操作技術規程[M].上海:上海科學技術出版社, 2007:5-20.
3. 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.
4. Lee S, Charters AC, Chandler JG, et al.A technique for orthotopic liver transplantation in the rat[J].Transplantation, 1973, 16(6):664-669.
5. 姚坤厚, 高毅, 潘明新, 等.大鼠原位肝移植急性排斥模型的建立[J].實用醫學雜志, 2008, 24(8):1304-1306.
6. Tan F, Chen Z, Zhao Y, et al.Novel technique for suprahepatic vena cava reconstruction in rat orthotopic liver transplantation[J].Microsurgery, 2005, 25(7):556-560.
7. 劉靜, 孫爾維, 汪爽, 等."開放灌注四牽三縫二橫一拉"法行大鼠原位肝移植[J].中華器官移植雜志, 2005, 26(11):695-697.
8. Miyata M, Fischer JH, Fuhs M, et al.A simple method for ortho-topic liver transplantation in the rat.Cuff technique for three vas-cular anastomoses[J].Transplantation, 1980, 30(5):335-338.
9. Kashfi A, Mehrabi A, Pahlavan PS, et al.A review of various techniques of orthotopic liver transplantation in the rat[J].Tran-splant Proc, 2005, 37(1):185-188.
10. 張華, 楊定華, 彭民浩.改良"二袖套法"大鼠原位肝移植及早期并發癥預防[J].中國現代手術學雜志, 2007, 11(4):247-250.
11. 張國偉, 周杰, 趙宏峰, 等.改良Kamada法大鼠肝移植并發癥的常見因素及預防[J].中國臨床解剖學雜志, 2009, 27(3):363-365.
12. 馬毅, 何曉順, 陳規劃.大鼠原位肝移植模型的手術技巧及并發癥的預防[J].中華顯微外科雜志, 2003, 26(1):45-47.
13. Matevossian E, Doll D, Hüser N, et al.Liver transplantation in the rat:single-center experience with technique, long-term survival, and functional and histologic findings[J].Transplant Proc, 2009, 41(6):2631-2636.
14. Ariyakhagorn V, Schmitz V, Olschewski P, et al.Improvement of microsurgical techniques in orthotopic rat liver transplantation[J].J Surg Res, 2009, 153(2):332-339.
15. Ma M, Ma ZH.Effect of tumor necrosis factor-alpha in rats with hepatic ischemia-reperfusion injury[J].Hepatobiliary Pancreat Dis Int, 2008, 7(3):296-299.
16. Camacho VR, de Fraga RS, Cerski CT, et al.Relationship bet-ween ischemia/reperfusion injury and the stimulus of fibrogenesis in an experimental model:comparison among different preservation solutions[J].Transplant Proc, 2011, 43(10):3634-3637.
17. Wang H, Li C, Hu J, et al.Effect of different suprahepatic vena cava reconstruction methods on the hemodynamics of rats after liver transplantation[J].PLoS One, 2013, 8(9):e72695.
18. Aguirre-Avalos G, Covarrubias-Velasco MA, Rojas-Sánchez AG.Venous outflow obstruction and portopulmonary hypertension after orthotopic liver transplantation[J].Am J Case Rep, 2013, 14:354-358.
19. De Gasperi A, Feltracco P, Ceravola E, et al.Pulmonary comp-lications in patients receiving a solid-organ transplant[J].Curr Opin Crit Care, 2014, 20(4):411-419.
20. Feltracco P, Carollo C, Barbieri S, et al.Early respiratory comp-lications after liver transplantation[J].World J Gastroenterol, 2013, 19(48):9271-9281.
21. 劉靜, 李江, 張升寧, 等.大鼠減體積肝移植腹腔出血的原因分析[J].南方醫科大學學報, 2010, 30(5):1075-1078.
22. Lausada NR, Gondolesi GE, Ortiz E, et al.Orthotopic liver transplant in rats.Surgical technique, complications and treatment[J].Acta Gastroenterol Latinoam, 2002, 32(2):63-70.
23. Kobayashi E, Kamada N, Goto S, et al.Protocol for the technique of orthotopic liver transplantation in the rat[J].Microsurgery, 1993, 14(8):541-546.
24. 彭方興, 鄭本波, 劉立新, 等.大鼠原位肝移植動物模型制作要點[J].中國普外基礎與臨床雜志, 2005, 12(2):117-119.
25. Mehrabi A, Fonouni H, Müller SA, et al.Current concepts in transplant surgery:liver transplantation today[J].Langenbecks Arch Surg, 2008, 393(3):245-260.
26. Karp SJ, Johnson S, Evenson A, et al.Minimising cold isch-aemic time is essential in cardiac death donor-associated liver transplantation[J].HPB (Oxford), 2011, 13(6):411-416.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Analysis of The Death Causes of Postoperative Early-Stage after Orthotopic Liver Transplantation in Rats and Their Solution Strategies

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