A four-technique comparative study of orthotopic liver transplantation in the rat

A four-technique controlled study was conducted on rat liver isografting to compare the microsurgical technique (Group 1), the two-cuff technique (Group 2), the three-cuff technique (Group 3), and a newly developed splinting suture technique (Group 4). The 60 day survival rates were significantly better in Groups 2 and 4 than in Groups 1 and 3. The anhepatic phase was significantly shorter with the cuff and splinting techniques than with the microsurgical technique, and total hepatic ischemic time was significantly shorter in the splint group than in the other three groups. Hepatic failure and shock had a higher incidence in those groups displaying a longer total hepatic ischemia time and a longer anhepatic phase. The results of this study show that the two-cuff technique and the splinting technique have substantial advantages over the microsurgical technique and the three-cuff technique. In particular, the splinting technique is preferable to the two-cuff technique because total hepatic ischemia time is shorter, and it is faster for a well-trained microsurgeon to learn this procedure than to learn the cuff technique de novo.