Orthotopic liver retransplantation in rats

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Abstract
A surgical experience with a method of rat orthotopic liver retransplantation (OLRT), and a preliminary study of immunological responses after OLRT are reported. OLRT was performed on the same recipient after the first orthotopic liver transplantation (1st‐OLT) according to our original (Kamada's) cuff method. Replacement of the portal vein (PV) and infra‐hepatic vena cava (IHVC) cuffs was not technically difficult. However, there were no survivors from the first 6 retransplanted rats, mainly due to complications from defective supra‐hepatic vena cava (SHVC) anastomoses. Unlike the human intra‐abdominal SHVC, the posterior wall of the intraabdominal SHVC in rats is too short and fragile to perform an end‐to‐end anastomosis twice between donor and recipient SHVC. For a second group of seven retransplants, a modification of the SHVC anastomosis was made between donor and recipient SHVC in conjunction with the recipient's cuff diaphragm. This enabled reanastomosis to be secure, resulting in the improved 1‐week survival after isogeneic OLRT (85.7%). This OLRT model has been applied to the fully allogeneic combination for several immunological studies and led to novel findings. Thus, an experimental model of a rat orthotopic liver retransplant model has the potential to allow more valuable insights into the immunological study of chronic rejection, sensitization and chimerism following liver retransplantation.