Partial Hepatic Autotransplantation With Complete Revascularization in the Dog

Abstract

AUXILIARY homotransplantation of the liver raises several problems apart from those having to do with immunosuppression. Revascularization of the transplanted liver is complicated by the dual hepatic blood supply. Most of the evidence obtained from homotransplantation studies suggests that splanchnic venous blood must perfuse the portal bed of the transplant for long-term hepatocyte integrity.^1-3These results, however, are somewhat confused by the effects of required hepatotoxic immunosuppressive agents. Experiments using partial portacaval transpositions have yielded conflicting results^4,5in regard to the role of portal blood. A reliable source of donor hepatic tissue has remained a major obstacle in clinical transplantation studies. It has been suggested that a part of the human liver from a live donor might serve as a life supporting transplant.⁶ A technique of partial hepatic autotransplantation with complete revascularization was developed in the dog in an attempt to answer certain aspects of these problems.