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  • Title: Split portal flow in heterotopic hepatic transplantation.
    Author: Lilly JR, Anderson KD, Altman RP, Randolph JG.
    Journal: J Pediatr Surg; 1975 Jun; 10(3):339-48. PubMed ID: 1095711.
    Abstract:
    Heterotopic hepatic transplantation was carried out in 31 pigs using three different methods of homograft revascularization. In one experimental group the host portal inflow was split between the homograft and native liver so that the graft was provided with intestinal-pancreatic effluent; the host liver with gastric-splenic venous blood. The liver grafts flourished in this environment. A small and variable degree of atrophy took place in the host liver. In the other two experimental groups in which the grafts were supplied with different kinds of systemic inflow only, atrophy invariably followed. Long-term homograft analysis was prevented by the intensity of immunologic rejection regardless of the location of the ectopic liver. The implications for clinical auxiliary liver transplantation are (1) heterotopic liver homografts must be supplied with a portal inflow from the host splanchnic bed, but (2) the total host splanchnic effluent is unnecessary. (3) The portal inflow must contain the pancreatic venous blood. (4) There is a criticial recipient--donor size relationship for successful portal revascularization in this type of auxiliary hepatic graft.
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