[Porcine liver transplantation using warm ischemic grafts]

Twenty-four porcine orthotopic liver transplantation were performed using temporary portal vein arterialization technique in an attempt to investigate (1) the influence of warm ischemia time of the donor liver on recipient survival and (2) significance of intraoperative changes of GOT, hyaluronic acid (HA), and amount of bile excretion for graft viability. The animals were divided into three groups according to warm ischemia time; group I (0 min, n = 9), group II (30 min, n = 8), and group III (60 min, n = 7). In group I all the animals survived more than 4 days, while in group II all died within 30 hours due to graft failure. In group II there were survivors (4 pigs lived for 2, 5, 6, 14 days) and non-survivors (4 pigs died within 12 hours). Although GOT values of groups II and III were significantly higher than those of group I after revascularization of the grafted liver, there was no difference between group II and III. There was also no difference between survivors and non-survivors in group II. HA values showed steep increase during operation in all three groups, but there were no differences among them. Bile was collected for 90 minutes after revascularization of the donor liver, and the amount in group I was significantly higher than those in groups II and III. Furthermore, comparing survivors and non-survivors in group II, the former excreted significantly more bile than the latter. In our experimental settings, it could be concluded that (1) 30 minutes of warm ischemia was an upper limit for recipient survival, and (2) the amount of bile excretion during 90 min after revascularization of the donor liver reflected the graft viability whereas intraoperative changes of GOT and HA did not.