Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastrointest Surg. Aug 27, 2026; 18(8): 120360
Published online Aug 27, 2026. doi: 10.4240/wjgs.120360
Published online Aug 27, 2026. doi: 10.4240/wjgs.120360
Sutureless portal vein reconstruction in porcine orthotopic liver transplantation using a microvascular coupler: A randomized study with artificial intelligence-assisted histopathology
Jun-Jie Li, Jian Yang, Jia-Ming Shang, Jiang Li, Chi-Yi Chen, Department of Liver Transplan
Yan Xie, Wen-Tao Jiang, Department of Liver Transplantation, First Central Hospital of Tianjin Medical University, Tianjin 300380, China
Li-Na Liu, Zhong-Ying Zhang, Bing-Hui Pan, Hua Rong Ke Chuang Biotechnology (Tian Jin) CO. Ltd, Tianjin 300192, China
Co-first authors: Jun-Jie Li and Jian Yang.
Co-corresponding authors: Yan Xie and Wen-Tao Jiang.
Author contributions: Li JJ and Yang J contributed equally to this article as co-first authors; Li JJ and Jiang WT conceived the study and performed critical revision of the manuscript for important intellectual content; Xie Y, Shang JM, Li J, Chen CY, Liu LN, Zhang ZY, and Pan BH collected the data; Yang J drafted the manuscript; Jiang WT and Xie Y contributed equally to this article as co-corresponding authors; and all authors thoroughly reviewed and endorsed the final manuscript.
AI contribution statement: We have written the response to reviewers from scratch, without any AI involvement whatsoever. It is assured that no AI software (DeepSeek, ChatGPT, etc.) was used in preparing this response.
Supported by Key Project of Scientific Research Plan of Tianjin Municipal Education Commission, No. 2024ZXZD010; Project of Tianjin Science and Technology Bureau Applied Basic Research, No. 23JCYBJC01800; and Beijing Hepatobiliary Sympathy Foundation Special Fund, No. iGandan-1082025-RGG009.
Institutional animal care and use committee statement: All procedures involving animals were reviewed and approved by the Institutional Animal Care and Use Committee of A-Jentec Institutional, approval No. ZH20231207P.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
ARRIVE guidelines statement: The authors have read the ARRIVE guidelines, and the manuscript was prepared and revised according to the ARRIVE guidelines.
Data sharing statement: The datasets generated and analyzed during the current study are available from the corresponding author upon reasonable request.
Corresponding author: Wen-Tao Jiang, Dean, Chief Physician, Full Professor, Department of Liver Transplantation, First Central Hospital of Tianjin Medical University, No. 2 Baoshan West Road, Xiqing District, Tianjin 300380, China. jiangwentao@nankai.edu.cn
Received: February 25, 2026
Revised: March 22, 2026
Accepted: May 25, 2026
Published online: August 27, 2026
Processing time: 173 Days and 13 Hours
Revised: March 22, 2026
Accepted: May 25, 2026
Published online: August 27, 2026
Processing time: 173 Days and 13 Hours
Core Tip
Core Tip: This randomized porcine orthotopic liver transplantation study evaluates a microvascular anastomotic coupler for sutureless portal vein reconstruction. Compared with hand-sewn anastomosis, the coupler shortened anastomosis time by about 12 minutes while maintaining 12-week patency and portal hemodynamics. Quantitative, artificial intelligence-assisted (human-verified) histopathology demonstrated fewer inflammatory cells and smaller necrotic areas around the anastomosis, supporting a favorable local tissue response. These findings indicate that a simple, standardized coupler can reduce warm ischemia and technical variability without sacrificing vascular integrity, offering a practical pathway to streamline portal reconstruction in liver transplantation.