Original Article
Copyright ©2010 Baishideng. All rights reserved.
World J Gastroenterol. Jul 7, 2010; 16(25): 3120-3132
Published online Jul 7, 2010. doi: 10.3748/wjg.v16.i25.3120
Comprehensive and innovative techniques for liver transplantation in rats: A surgical guide
Tomohide Hori, Justin H Nguyen, Xiangdong Zhao, Yasuhiro Ogura, Toshiyuki Hata, Shintaro Yagi, Feng Chen, Ann-Marie T Baine, Norifumi Ohashi, Christopher B Eckman, Aimee R Herdt, Hiroto Egawa, Yasutsugu Takada, Fumitaka Oike, Seisuke Sakamoto, Mureo Kasahara, Kohei Ogawa, Koichiro Hata, Taku Iida, Yukihide Yonekawa, Lena Sibulesky, Kagemasa Kuribayashi, Takuma Kato, Kanako Saito, Linan Wang, Mie Torii, Naruhiko Sahara, Naoko Kamo, Tomoko Sahara, Motohiko Yasutomi, Shinji Uemoto
Tomohide Hori, Feng Chen, Ann-Marie T Baine, Norifumi Ohashi, Christopher B Eckman, Aimee R Herdt, Naruhiko Sahara, Tomoko Sahara, Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, FL 32224, United States
Tomohide Hori, Yasuhiro Ogura, Toshiyuki Hata, Hiroto Egawa, Yasutsugu Takada, Fumitaka Oike, Seisuke Sakamoto, Mureo Kasahara, Kohei Ogawa, Koichiro Hata, Taku Iida, Yukihide Yonekawa, Naoko Kamo, Shinji Uemoto, Division of Hepato-Pancreato-Biliary, Transplant and Pediatric Surgery, Department of Surgery, Kyoto University Hospital, Sakyo-ku, Kyoto 606-8507, Japan
Justin H Nguyen, Lena Sibulesky, Division of Transplant Surgery, Department of Transplantation, Mayo Clinic, Jacksonville, Florida, FL 32224, United States
Xiangdong Zhao, Innovation Center for Immunoregulation Technologies and Drugs, Transplant Tolerance Unit, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto 606-8507, Japan
Shintaro Yagi, Institute for Laboratory Animal Science and Experimental Surgery, RWTH-Aachen University, D-52074 Aachen, Germany
Kagemasa Kuribayashi, Takuma Kato, Kanako Saito, Linan Wang, Mie Torii, Department of Cellular and Molecular Immunology, Mie University Graduate School of Medicine, Tsu, Mie 514-8507, Japan
Motohiko Yasutomi, New Zealand Liver Transplant Unit, Auckland City Hospital, Auckland 92024, New Zealand
Author contributions: Hori T, Zhao X, Ogura Y, Hata T, Yagi S, Chen F, Baine AMT, Ohashi N, Eckman CB, Herdt AR, Egawa H, Takada Y, Oike F, Sakamoto S, Kasahara M, Ogawa K, Hata K, Iida T, Yonekawa Y, Sibulesky L, Kuribayashi K, Kato T, Saito K, Wang L, Torii M, Sahara N, Kamo N, Sahara T and Yasutomi M contributed to the concept and to collecting/analyzing the data; Nguyen JH designed the study, and revised the draft critically for intellectual content; Nguyen JH and Uemoto S gave final approval of the published version and supervised the study; Hori T, Nguyen JH, Uemoto S, Ogura Y, Zhao X and Yagi S contributed equally to this work; Hori T analyzed the data and wrote the paper; Ogura Y provided the institutional text for this model; Zhao X, Takada Y, Egawa H, Oike F, Ogura Y, Sakamoto S, Kasahara M, Ogawa K and Hata T established the basis of this model and made surgical contributions to improve this model during the last 2 decades; Hata K, Yagi S, Iida T, Yonekawa Y, Eckman CB, Chen F, Baine AMT, Ohashi N, Herdt AR, Kuribayashi K, Kato T, Saito K, Wang L and Torii M supported collection of the data; Nguyen JH and Uemoto S supervised this study.
Supported by The work at the Mayo Clinic, Florida was supported by grants to Nguyen JH from the Deason Foundation, Sandra and Eugene Davenport, Mayo Clinic CD CRT-II, and NIH R01NS051646-01A2; the work in Kyoto University Graduate School of Medicine was supported by grants of the Japan Society for the Promotion of Science, No. C20591523 and the Uehara Memorial Foundation, No. 200940051, Tokyo, 171-0033, Japan
Correspondence to: Tomohide Hori, PhD, MD, Department of Neuroscience, Mayo Clinic, Birdsall Research Building, Room 323, 4500 San Pablo Road, Jacksonville, Florida, FL 32224, United States. horit@kuhp.kyoto-u.ac.jp
Telephone: +1-904-9532449 Fax: +1-904-9537117
Received: March 6, 2010
Revised: April 6, 2010
Accepted: April 13, 2010
Published online: July 7, 2010
Abstract

AIM: To investigate our learning curves of orthotopic liver transplantation (OLT) in rats and the most important factor for successful surgery.

METHODS: We describe the surgical procedures for our rat OLT model, and determined the operator learning curves. The various factors that contributed to successful surgery were determined. The most important surgical factors were evaluated between successful and unsuccessful surgeries.

RESULTS: Learning curve data indicated that 50 cases were required for operator training to start a study. Operative time, blood loss, warm ischemic time, anhepatic phase, unstable systemic hemodynamic state, and body temperature after surgery significantly affected surgery success by univariate analysis, while the anhepatic phase was the most critical factor for success by multivariate analysis.

CONCLUSION: OLT in rats is the only liver transplantation model that provides clinically relevant and reliable results. Shortened anhepatic phase is key to success in this model.

Keywords: Animal model; Liver transplantation; Microsurgery; Rat; Reperfusion injury; Ultra-microsurgery