EXPERIMENTAL STUDIES ON AUXILIARY LIVER TRANSPLANTATION BASED ON REDOX THEORY

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1. Establishment of biochemical assays of porcine blood ketone bodies. In this study, it is essential to measure the changes in blood ketone body ratio (acetoacetate/b-hydroxybutyrate, KBR) in both arterial blood of the pigs with failed liver and hepatic vein of the auxiliary transplanted liver. We have found that arterial ketone bodies of th pigs are lower than those of men, rabbits, or rats.2. Partial hepatectomy model as a recipient. Initialy, we have tried to establish a liver failure model in 90% hepatectomized pig. However, a hemodynamically stable model could not be made mainly due to large blood loss. Auxiliary liver transplantation in this model resulted in decrease of KBR in both recipient and auxiliary liver. In this model, we have failed to evaluate the availability of KBR as an index of graft failure.3. Establishment of acute liver failure induced by liver ischemia in pigs with portacaval shunt. Acute liver failure was made by the clamping of the hepatic triads for 6 hours. During liver ischemia, the levels of transaminases, arterial ammonia, and potassium were increased gradually. PT and PTT were prolonged. During the hepatic triads clamping, the arterial ketone bodies were hardly detected. Within 2 hours after the declamping, arterial KBR was recovered temporally, but the ratio continued to decline. All pigs died within 8 hours after the declamping. It was suggested that by measuring the changes in arterial KBR in this model, the efficiency of metabolic support as provided by ex-vivo perfused liver or auxiliary transplanted liver could be assessed.4. Since auxiliary liver transplantation on this animal was found to be possible without large blood loss, we have begun to evaluate the availability of KBR as an index of graft failure in this model.