Study on Reconstruction of the Hepatic Artery and Superior Mesenteric Artery Using a Cryopreserved Graft

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Reconstruction of the hepatic artery and superior mesenteric artery is challenging in hepatobiliary surgery. The purpose of this study is to evaluate the feasibility of cryopreserved arterial grafting and to eliminate intraoperative hepatic ischemia during these procedures.1. The aorta of Wister rats was cryopreserved with a program-freezer. The preserved aorta was transplanted to a recipient rat using a microsurgical technique under the condition of purulent peritonitis. Histologically, the grafted aorta showed no infection and a normal process after cryopreserved arterial grafting, including temporary endothelial cell loss and intimal hyperplasia.2. Reconstruction of the hepatic artery and superior mesenteric artery of pigs was difficult because of thick lymphatic channels.3. Rats receiving 90-min hepatic ischemia were divided into group C (control), group U treated with Urge-8, an antineutrophil antibody andgroup F treated with FK506, an immunosuppressor. Liver enzymes, pH, interleukin-8 (IL-8), and arterial ketone body ratio (AKBR) were measured 1 hour and 1 week after hepatic reperfusion. Survival rates were compared. Histologic damages of the liver were studied and the number of hepatic neutrophil infiltration was counted using ASD staining. One week-survival rate was tended to be lower in group C (12/20) than in groups U (16/20) and F (15/19). One hour after reperfusion of the liver, levels of GOT, GPT, LDH, and IL-8, hepatic neutrophil counts, and degree of hepatic damages were higher in group C than in groups U and F. Most of these changes subsided 1 week after grafting.4. Although hepatic tissue PO2 levels showed the presence of hepatic ischemia, it did not correlate to the degree of hepatic ischemic injury.In conclusion, this study indicated the safety of cryopreserved arterial grafting in the presence of peritnitis and efficacy of netrophil suppression therapy for hepatic ischemia