High incidence of biliary complications in rat liver transplantation:Can we avoid it?

AIM:To investigate how to reduce the incidence of biliary complications in rat orthotopic liver transplantation.METHODS:A total of 165 male Wistar rats were randomly divided into three groups:Group A,orthotropic liver transplantation with modified "two-cuff" technique;Group B,bile duct was cut and reconstructed without transplantation;and Group C,only laparotomy was performed.Based on the approaches used for biliary reconstruction,Group A was divided into two sub-groups:A1(n = 30),duct-duct reconstruction,and A2(n = 30),duct-duodenum reconstruction.To study the influence of artery reconstruction on bile duct complication,Group Bwas divided into four sub-groups:B1(n = 10),duct-duct reconstruction with hepatic artery ligation,B2(n = 10),duct-duct reconstruction without hepatic artery ligation,B3(n = 10),duct-duodenum reconstruction with hepatic artery ligation,and B4(n = 10),duct-duodenum reconstruction without hepatic artery ligation.The samples were harvested 14 d after operation or at the time when significant biliary complication was found.RESULTS:In Group A,the anhepatic phase was 13.7 ± 1.06 min,and cold ischemia time was 50.5 ± 8.6 min.There was no significant difference between A1 and A2 in the operation duration.The time for biliary reconstruction was almost the same among all groups.The success rate for transplantation was 98.3%(59/60).Significant differences were found in the incidence of biliary complications in Groups A(41.7%),B(27.5%) and C(0%).A2 was more likely to have biliary complications than A1(50% vs 33.3%).B3 had the highest incidence of biliary complications in Group B.CONCLUSION:Biliary complications are almost inevitable using the classical "two cuff" techniques,and duct-duodenum reconstruction is not an ideal option in rat orthotopic liver transplantation.