[Experimental study of multi-visceral transplantation in dogs]

The purpose of the present study was to examine the technical, functional and immunologic aspects in the multivisceral transplantation using canine model. After removal of upper abdominal organs en bloc, the composite graft including the liver, pancreas, spleen and duodenum was orthotopically transplanted in 35 dogs. Ten recipients survived more than 3 days, and 6 more than 6 days. Cause of early death was massive lymphatic leakage, and late death was due to acute rejection or other complications. As technical considerations, perfusion of the graft should be only via aorta to prevent pancreatic edema, and reperfusion should be at first with arterial blood flow to minimize the ischemic damage of the graft. Hepatic and pancrease-endocrine functions were recovered by 3 days, after grafting, and 2-3 days later pancreas-exocrine function was restored. Thereafter the hepatic function was progressively deteriorated again from 6 to 8th day, although the pancreatic function was well maintained until death. At autopsy this hepatic dysfunction was histologically confirmed to be caused by severe acute rejection. On the other hand, the pancreas and duodenum were morphologically almost normal. The results demonstrated the dissociation in functional recovery after grafting and extent of rejection reaction among each grafted organ in the multivisceral transplantation.