Evaluation of small-for-size liver transplantation and auxiliary partial orthotopic liver transplantation with small-for-size graft for porcine acute hepatic failure

Objective To evaluate the short-term efficacy of small-for-size liver transplantation (LT) and auxiliary partial orthotopic liver transplantation (OLT) with small-for-size graft for porcine acute hepatic failure. Methods The pigs with acute liver failure were randomized into 3 groups. The animals in group A received total OLT (n=5), those in group B small-for size LT (n=5) and those in group C auxiliary partial OLT with small-for-size graft (n = 5). The recipient's portal vein pressure (PVP) was determined at laparotomy, immediately after splenectomy and 30 min after reperfusion, respectively. The clinical manifestations, biochemical and pathological changes and 7-d survival rate were investigated in the 3 groups. Results The graft-to-recipient weight ratio was (2. 44±0. 30)%, (0. 76±0. 02)% and (0. 75±0. 03)% in the 3 groups, respectively. The PVP was significantly higher in group A than in group B and C 30 min after reperfusion (P0. 01). The PVP of native liver was markedly higher than that of graft liver in group C (P0. 05). The levels of AST, T-Bil, PT, lactate and ammonia in group A and C began to decrease on postoperative day (POD) 2 and returned to normal on POD 7. Higher values of AST, T-Bil, PT, lactate and ammonia were found in group B during POD 2-4 (P0. 05). The 7-d survival rate was remarkably higher in group A and B than in group C (P0. 05). Conclusions The short-term efficacy of auxiliary partial OLT with small-for-size graft is better than that of small-for-size LT for acute porcine hepatic failure. It is not necessary to intervene with the native liver portal vein upon application of auxiliary partial OLT with small-for-size graft for acute hepatic failure.