Auxiliary en-bloc liver-small bowel transplantation with partial pancreas preservation in pigs

AIM: The aim of this study was to describe an auxiliarycombined liver-small bowel transplantation model with thepreservation of duodenum,head of pancreas and hepaticbiliary system in pigs.The technique,feasibility,securityand immunosuppression were commented.METHODS: Forty outbred long-white pigs were randomizedinto two groups,and the auxiliary composite liver/smallbowel allotransplantations were undertaken in 10 long-white pigs in each group with the recipient liver preserved.Group A was not treated with immunosuppressive drugswhile group B was treated with cyclosporine A andmethylprednisolone after operation.The hemodynarnicchanges and amylase of body fluid (including blood,urineand abdominal drain) were analyzed.RESULTS: The average survival time of the animals was10±1.929 d (6 to 25 d) in group A while more than 30 d ingroup B.The pigs could tolerate the hemodynamic fluctuationduring operation and the hemodynamic parameters recoveredto normal 2 h after blood reperfusion.The transient highamylase level was decreased to normal one week afteroperation and autopsy showed no pancreatitis.CONCLUSION: Auxiliary en-bloc liver-small boweltransplantation with partial pancreas preservation is afeasible and safe model with simplified surgical techniquesfor composite liver/small bowel transplantation.This modelmay be used as a preclinical training model for clinicaltransplantation method,clinical liver-small bowel transplan-tation related complication research,basic research includingimmunosuppressive treatment,organ preservation,acuterejection,chronic rejection,immuno-tolerance andxenotransplantation.