Total Hepatectomy Model in Pigs: Revised Method for Vascular Reconstruction Using a Rigid Vascular Prosthesis

Total hepatectomy in animals provides an irreversible model of acute liver failure. Vascular reconstruction in this model of acute liver failure was modified and characterized for the use of assessment of liver support systems. Pigs underwent total hepatectomy and a rigid three-way transparent polyethylene vascular conduit was used to replace the retrohepatic caval vein and to shunt the portal venous blood to the caval vein. Placement of the vascular conduit in conjunction with excision of the liver was completed in 10-22 min without the need of a temporary veno-venous bypass. A survival study conducted in 5 animals showed a mean survival time of 46 +/- 6 h. Baseline and 4 h postoperative hemoglobin levels were not different, and plasma ammonia levels rose to more than 30-fold of baseline values. All animals died of cardiac arrhythmias and irreversible shock. Total hepatectomy in the pig using a three-way portal-venous conduit is a reliable and well-reproducible animal model of acute liver failure for evaluation of liver assist devices.