[Morphology of transplanted liver. an experimental study (author's transl)]

Experimental orthotopic livertransplantation is a very difficult procedure (Largiadér). This is due to the difficult specific anatomy of the liver, the high sensibility of the liver against anoxia and the distrubance of blood coagulation during transplantation. This investigation demonstrates that ischemia does not only damage the livercells, but also the bile ducts. We could show that these changes on the bile ducts are responsible for a certain number of unsuccessfull results of livertransplantations. In basic experiments we could demonstrate that ischemia is the cause of bile duct changes. There is always a critical situation for the common bile duct, when we tie the hepatic artery and dissect simultaneously the common bile duct. To keep this changes to a minimum we pay attention to the following points: 1. Correct perfusion and cooling of the livertransplant. 2. Fast recirculation of the hepatic artery before performing portal anastomosis. 3. The dissection of the common bile duct near the duodenum to preserve collaterale vessels from the proprial hepatic artery considering the specific anatomy.