A comparison of portal versus systemic venous drainage in the pig small-bowel allograft recipient

The influence of portal versus systemic venous drainage on liver function, nutrition, and metabolism was studied in the pig small bowel allograft model. A total of 17 pigs received orthotopic small-bowel transplants with either portal or systemic venous drainage. There was no difference in survival between groups. No significant hepatic or metabolic abnormalities that are known to occur in total portosystemic shunting were seen in the group that underwent systemic venous drainage. Alterations in ammonia levels and amino acid analysis between both groups were minor. Histologic evidence of liver atrophy was not observed. Significant nutritional abnormalities were not seen, although weight gain was compromised in both groups. Our findings suggest that systemic venous drainage would be preferable in small-bowel transplantation because it is technically easier and safer to perform in the clinical setting.