The study was supported by research grants from the Roche Organ Transplant Research Foundation (ROTRF) and Astellas. Markus Selzner was supported by an ASTS Career Development Award. Matthias Knaak was supported by the Astellas Research Scholarship. We thank Uwe Mummenhoff and the Birmingham family for their generous support.

<ol>
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The authors have nothing to disclose.

Experimental Schweine OLTx ist ein anspruchsvolles Verfahren für ein Forschungs Einstellung ohne die Intensiv Ressourcen eines klinischen Szenario. Mögliche Komplikationen sind hämodynamische Instabilität, Blutungen, Organ Ischämie, Hypothermie, und Stoffwechsel sowie der Atemwege, Dekompensation. Für jede Arbeitsgruppe, genügt Verfahrens Ausbildung der Operationstechnik 5 als auch das Schwein Anästhesie 14,15 um repräsentative und reproduzierbare Ergebnisse zu erhalten obligatorisch. Vielen technischen Feinheiten sind in der Literatur beschrieben worden, insbesondere in Bezug auf die Gefäßrekonstruktion Phase 5. Die oben beschriebene OLTx Protokoll bietet die erforderlichen Informationen für einen Sekt-Austausch-Modell ähnelt menschlichen OLTx. Die zur Verfügung gestellten Ergebnisse zeigen zuverlässig das Überleben der Tiere und Graft Erholung in beiden HBD und DCD-Modelle. Das Protokoll ist in kurzfristige Überleben Szenarien in Graft Reperfusion expe gebraucht wird,riments zum Beispiel als auch in Langzeitüberleben Modelle wie Toleranzstudien. Ein großes Hindernis von Schweine OLTx ist die relativ schlechte Toleranz Cava und Pfortader Querspann. Splanchnischen Staus während der anhepatischen Phase verursacht venösen Bluthochdruck und Kapillare Schäden, die zu den wichtigsten Darmischämie und hämodynamische Instabilität auf den Punkt eines irreversiblen Schock auch nach Organ Reperfusion 7 führen kann. Da die Hohlvene vollständig in Leberparenchym eingebettet, ist ein Cava erhaltHuckepackVerfahren nicht durchführbar. Die Gesamt Okklusion der Vena Cava im Cava Wiederaufbauphase beeinträchtigt die hämodynamische Stabilität des Schweins. Obwohl einige Berichte zeigen, dass Schweine OLTx während insgesamt Cava und Pfortader Okklusion von weniger als 25 min 16,17 erreicht werden, ist eine porto-cava-Halsschlag Bypass Technik zum Zeitpunkt der Gefäßrekonstruktion der sicherer und praktischer Option 7- 9,18. In thErfahrung e Autoren, ist eine passive porto-Halsschlag Bypass nicht optimal, das Schwein hämodynamisch während der anhepatischen Phase stabil zu halten. Die Bypass-Modell, einschließlich der aktiven Druckverlust beider infrahepatische Cava und Pfortader, ermöglicht ein ruhiges Wiederaufbauphase der suprahepatischen caval und Portal Anastomosen sogar mit erweiterten Klemmzeit aufgrund unvorhergesehener Komplikationen. Im Gegensatz zu früheren Berichten 7 eine Splenektomie nicht zwingend erforderlich, wenn das Portal Bypasskatheter wird entfernt. Sowohl Milz Arterie und Vene sind etwa auf halbem Weg entlang der Länge der Milz Verlassen der proximalen Hälfte ausreichend durchblutet geschlossen. Komplikationen wie Blutungen oder Luftembolie durch Bypass-Abschaltung sind vermeidbar, indem sichergestellt wird, dass der Bypass wird sorgfältig platziert und ordnungsgemäß gesichert. In langfristige Überleben OLTx Experimenten wird die Gallenganganastomose aufgrund seiner hohen Komplikationsrate 19 als eine Schwachstelle. Die Gallengewebe ist sehr zerbrechlich und needs besondere Sorgfalt bei der Handhabung. Viele verschiedene Anastomose Techniken wurden beschrieben 5,19. Eine End-zu-End-Anastomose ist technisch einfach und mit minimalem Komplikationen 19 verbunden. Eine fortlaufende Naht mit einer nicht-schneidenden Nadel darunter große Abschnitte peribiliären Bindegewebe erscheint überlegen einer unterbrochenen Naht. Der Gallengang wird unter unnötige Spannung gesetzt, wenn die einzelnen Maschen der Knopfnaht verknotet werden. Dies kann in Gewebe Tränen und in Folge Galle Lecks führen. Das Nahtmaterial - resorbierbar oder nicht resorbierbar - ist in der Regel nicht von Bedeutung, da ihre begrenzte Lebensdauer, bis das Schwein wird beendet. Für langfristige Überleben Modelle über mehrere Monate, resorbierbares Nahtmaterial - bevorzugt - wie in der menschlichen OLTx. Besondere Sorgfalt muss mit der postoperativen Follow-up genommen werden. Ausreichende Ernährung und Flüssigkeitszufuhr, eine zuverlässige Schmerzlinderung Protokoll und eine richtige ImmunsuppressionRegime sind obligatorisch. Für Langzeitversuche, erscheint Immunsuppression besonders wichtig. Im Vergleich zu anderen Säugetieren, Schweine zeigen eine überraschend geringe immunologische Abstoßung Rate nach OLTx 20,21. Knopfzelle Infiltrationen sind in der zweiten Woche nach der Transplantation maximale und verringern spontan auch ohne Immunsuppression. Die Ablehnung ist nur selten die Todesursache nach Schweine OLTx 22. Aber auch bei der Immunsuppression Protokoll mit der Verwaltung hier genannten Steroide iv und po Calcineurin-Inhibitoren, Transplantatabstoßung wird durch eine leichte Erhöhung der Transaminasen ab etwa 4 Tage nach OLTx angegeben und durch scheinbare Portal Feldrundzellinfiltration bestätigt. Calcineurin-Inhibitoren gegeben entweder po oder iv 23,24 25,26 werden; Beide Methoden haben Nachteile. Auch bei oraler Applikationshilfen, bleibt die tatsächliche Menge Erreichen des Gastrointestinaltraktes schwer fassbar. Auf der anderen Seite, kontinuierlichen iv-Infusion inein Schweinestall mit einer aktiven Tier ist schwierig. Daher muß der iv Applikation in Form eines Bolus, der in hohen Wirkstoffkonzentrationsspitzen zusammen mit potentiellen toxischen Wirkungen führt geführt werden. Dennoch beide Anwendungsverfahren anscheinend langfristige Überleben zu ermöglichen. Ähnlich wie bei einer klinischen Umgebung, wird postoperativen Stress-Ulkus-Prophylaxe empfohlen. Postoperative Blutungen aus Magengeschwüren ist ein häufiges Problem und kann zu einer Leberfunktions 27 bezogen werden. Nach ein paar Fälle von Magen-Darm-Blutungen in beiden OLTx Gruppen begannen die Autoren regelmäßige Prophylaxe mit Pantoprazol und keine gastrointestinalen Blutungen seitdem erleben. Strikte Aufrechterhaltung steriler Bedingungen, intraoperativ, vergleichbar mit den Verhältnissen in einer klinischen Operationsraum und folglich Antibiotikaprophylaxe, verringert das Risiko von infektiösen Komplikationen. Zusammenfassend diesem Artikel provides praktische Informationen für den Aufbau einer Schweine OLTx Programm in einem Forschungs Einstellung. Ausreichend Engagement, Praxis und Teamarbeit ist, um die Lernphase zu verringern, um zuverlässige Ergebnisse zu erzeugen, und um die Kosten und die Anzahl der Versuchstiere zu reduzieren wichtig.

Lebertransplantation (OLTx) ist die einzige Behandlungsoption für Patienten im Endstadium einer Lebererkrankung oder fortgeschrittenem Leberzellkarzinom. In den letzten 25 Jahren hat sich die Zahl der Kandidaten auf der Warteliste nach und nach erhöht und jetzt weit die Anzahl der verfügbaren Transplantate überschreitet. In den meisten Regionen der Transplantation, 20 bis 30% der Patienten auf der Warteliste für eine Lebertransplantation sterben, ohne eine Organtransplantation oder durch Fortschreiten der Krankheit ausgelistet. Strategien, um die Spenderpool zu erhöhen und damit die Anzahl der verfügbaren Transplantate, werden dringend benötigt. Erweiterte Kriterien Organzuteilung, verlängerte Transplantaterhaltung, und die Induktion von Immuntoleranz noch stellen eine große klinische Herausforderung 1-3. Daher ist experimentelle OLTx Forschung entscheidende, um klinische OLTx Praxis zu optimieren. Porcine OLTx ist ein gut etabliertes experimentellen Modell, das menschliche OLTx in vielerlei Hinsicht einschließlich l ähneltiver Größe, Anatomie und Physiologie 4-6. So hat es sich zu einem Standard experimentelle Methode in Forschungsbereichen wie Operationstechniken, Physiologie, Immunologie, Erhaltung und Ischämie-Reperfusionsschaden. Zahlreiche Techniken der Transplantat Beschaffung Empfänger Hepatektomie, und insbesondere eine Gefäßrekonstruktion, wurden in der Literatur 5 beschrieben. Die Wahl der geeigneten Technik variiert je nach Präferenz des Forschers und technische Leistungsfähigkeit. Im Gegensatz zum menschlichen Szenario splanchnic Staus während des anhepatischen Phase repräsentiert ein wichtiges Problem in porcine OLTx. Nachfolgende Darmischämie und kongestive Gefäßschäden kann schwere hämodynamische Instabilität verursachen, zu gefährden das Schwein Überleben und damit den Erfolg des Experiments 7-9. Daher ist eine ausreichende Darm Dekompression verpflichtend, vor allem in weniger technisch verfeinert experimentellen Einstellungen. Unsing eine aktive porto-Kava-Halsschlag Shunt für die Dauer des anhepatischen Phase ist eine zuverlässige Möglichkeit, Darm-Staus zu vermeiden. Das System kann für frühen Reperfusion Experimenten als auch langfristige Überleben Szenarien verwendet werden. Das folgende Protokoll enthält alle Informationen für eine stabile und reproduzierbare Lebertransplantationsmodell in Schweinen, einschließlich Spenderleber Beschaffung, Empfängerbetrieb einschließlich Hepatektomie und End-to-End-Schiff Rekonstruktionstechniken und postoperative Pflege.

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			<td height="19" style="height:19px;width:276px;">Atropine Sulphate 15mg/30mL</td>
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		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:276px;">Protamine Sulfate 50mg/5mL</td>
			<td style="width:257px;">Pharmaceutical Partners of Canada Inc.</td>
			<td align="right" style="width:201px;">2139537</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:276px;">Saline 0.9%, 1L</td>
			<td style="width:257px;">Baxter Corporation</td>
			<td align="right" style="width:201px;">60208</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:276px;">Sodium Bicarbonate 50 mEq/50mL</td>
			<td style="width:257px;">Hospira Healthcare Corporation</td>
			<td align="right" style="width:201px;">261998</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:276px;">Solu-Medrol 500mg</td>
			<td style="width:257px;">Pfizer Canada Inc.</td>
			<td align="right" style="width:201px;">2367963</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:276px;">Tranexamic Acid 1000mg/10mL</td>
			<td style="width:257px;">Pfizer Canada Inc.</td>
			<td align="right" style="width:201px;">2064413</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:276px;">University of Wisconsin Solution, SPS-1</td>
			<td style="width:257px;">Organ Recovery Systms</td>
			<td style="width:201px;">SPS-1</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:276px;">Xylocaine Endotracheal 10mg/50mL</td>
			<td style="width:257px;">AstraZeneca</td>
			<td align="right" style="width:201px;">2003767</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="19">
			<td height="19" style="height:19px;"></td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr height="19">
			<td height="19" style="height:19px;width:276px;">Appose ULC 35W skin stapler</td>
			<td style="width:257px;">Covidien Canada</td>
			<td align="right" style="width:201px;">803712</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="19">
			<td height="19" style="height:19px;width:276px;">Maxon, 1</td>
			<td style="width:257px;">Covidien Canada</td>
			<td align="right" style="width:201px;">606173</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="19">
			<td height="19" style="height:19px;width:276px;">Sofsilk, 0</td>
			<td style="width:257px;">Covidien Canada</td>
			<td style="width:201px;">S606</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="19">
			<td height="19" style="height:19px;width:276px;">Sofsilk, 2-0</td>
			<td style="width:257px;">Covidien Canada</td>
			<td style="width:201px;">S405</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="19">
			<td height="19" style="height:19px;width:276px;">Sofsilk, 3-0</td>
			<td style="width:257px;">Covidien Canada</td>
			<td style="width:201px;">S404</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="19">
			<td height="19" style="height:19px;width:276px;">Surgipro II, 4-0</td>
			<td style="width:257px;">Covidien Canada</td>
			<td style="width:201px;">VP581X</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="19">
			<td height="19" style="height:19px;width:276px;">Surgipro II, 5-0</td>
			<td style="width:257px;">Covidien Canada</td>
			<td style="width:201px;">VP725X</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="19">
			<td height="19" style="height:19px;width:276px;">Surgipro II, 6-0</td>
			<td style="width:257px;">Covidien Canada</td>
			<td style="width:201px;">VP733X</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="19">
			<td height="19" style="height:19px;width:276px;"></td>
			<td style="width:257px;"></td>
			<td style="width:201px;"></td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="19">
			<td height="19" style="height:19px;width:276px;">Catheter i.v, 18 G</td>
			<td style="width:257px;">BD Canada</td>
			<td align="right" style="width:201px;">381147</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="19">
			<td height="19" style="height:19px;width:276px;">Cook TPN catheter, 9.5Fr</td>
			<td style="width:257px;">Cook Medical Company</td>
			<td style="width:201px;">C-TPNS-9.5-90</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="19">
			<td height="19" style="height:19px;width:276px;">PSI Kit for sheath catheter, 8.5Fr</td>
			<td style="width:257px;">Arrow International</td>
			<td style="width:201px;">ASK-09803-UHN</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="19">
			<td height="19" style="height:19px;"></td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:276px;">Infusion Pump Line</td>
			<td style="width:257px;">Smith Medical ASD Inc.</td>
			<td style="width:201px;">21-0442-25</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:276px;">Liver Admin Set (flush line)</td>
			<td style="width:257px;">CardioMed Supplies Inc</td>
			<td align="right" style="width:201px;">17175</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:276px;">Mallinckrodt, Tracheal Tube, 6.5mm</td>
			<td style="width:257px;">Covidien Canada</td>
			<td align="right" style="width:201px;">86449</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:276px;">Med-Rx Suction Connecting Tube</td>
			<td style="width:257px;">Benlan Inc.</td>
			<td style="width:201px;">70-8120</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:276px;">Organ Bag</td>
			<td style="width:257px;">CardioMed Supplies Inc</td>
			<td align="right" style="width:201px;">2990</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:276px;">Suction Tip</td>
			<td style="width:257px;">Tyco Healthcare Group LP</td>
			<td align="right" style="width:201px;">8888501023</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:276px;">Valleylab, Cautery Pencil</td>
			<td style="width:257px;">Covidien Canada</td>
			<td style="width:201px;">E2515H</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:276px;">Valleylab, Patient Return Electrode</td>
			<td style="width:257px;">Covidien Canada</td>
			<td style="width:201px;">E7507</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:276px;"></td>
			<td style="width:257px;"></td>
			<td style="width:201px;"></td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:276px;">Bypass Connector 3/8&#8221; x 1/4&#8220;</td>
			<td style="width:257px;">Raumedic AG</td>
			<td style="width:201px;">955083-001</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:276px;">Bypass Connector 3/8&#8221; x 3/8&#8221; Luer Lock</td>
			<td style="width:257px;">Raumedic AG</td>
			<td style="width:201px;">955163-001</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:276px;">Bypass Connector Y 3/8&#8221; x 3/8&#8221; x 1/4&#8221;</td>
			<td style="width:257px;">Raumedic AG</td>
			<td style="width:201px;">961360-002</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:276px;">Bypass Tubing 1/4&#8221; x 1/16&#8221;</td>
			<td style="width:257px;">Raumedic AG</td>
			<td style="width:201px;">039505-010</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:276px;">Bypass Tubing 3/8&#8221; x 3/32&#8221;</td>
			<td style="width:257px;">Raumedic AG</td>
			<td style="width:201px;">039535-005</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:276px;">Rotaflow Cenrtifugal Pump</td>
			<td style="width:257px;">Maquet-Dynamed</td>
			<td style="width:201px;">HC 2821</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:276px;">Stainless Steel Hose Clamp Ring, 5mm</td>
			<td style="width:257px;">Oetiker</td>
			<td align="right" style="width:201px;">16700007</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="19">
			<td height="19" style="height:19px;"></td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:276px;">Abdominal Retractor</td>
			<td style="width:257px;">Medite GmbH</td>
			<td style="width:201px;">N/A</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:276px;">De Bakey &#8211; Beck, Infrahepatic Cava Clamp</td>
			<td style="width:257px;">Aesculap Inc.</td>
			<td style="width:201px;">FB519R</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:276px;">Diethrich, Atraumaitc Clamp (Portal Vein)</td>
			<td style="width:257px;">Aesculap Inc.</td>
			<td style="width:201px;">FB525R</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:276px;">Gregory Bull Dog Clamp, curved</td>
			<td style="width:257px;">Aesculap Inc.</td>
			<td style="width:201px;">FB382R</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:276px;">Gregory Bull Dog Clamp, straight</td>
			<td style="width:257px;">Aesculap Inc.</td>
			<td style="width:201px;">FB381R</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:276px;">Potts &#8211; De Martel, Scissors</td>
			<td style="width:257px;">Aesculap Inc.</td>
			<td style="width:201px;">BC648R</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:276px;">Satinsky, Suprahepatic Cava Clamp</td>
			<td style="width:257px;">Aesculap Inc.</td>
			<td style="width:201px;">FB605R</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:276px;">Symetrical Tubing Clamp</td>
			<td style="width:257px;">Codman Instruments</td>
			<td align="right" style="width:201px;">198010</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="19">
			<td height="19" style="height:19px;"></td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr height="19">
			<td height="19" style="height:19px;width:276px;">Anesthesia Machine, Optimax</td>
			<td style="width:257px;">Moduflex Anesthesia Equipment</td>
			<td style="width:201px;">SN5180</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="19">
			<td height="19" style="height:19px;width:276px;">Bypass Flow meter, HT 110</td>
			<td style="width:257px;">Transonic Systems Inc.</td>
			<td style="width:201px;">HT110B11106</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="19">
			<td height="19" style="height:19px;width:276px;">Flow meter probe, H6XL</td>
			<td style="width:257px;">Transonic Systems Inc.</td>
			<td style="width:201px;">H6Xl689</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="19">
			<td height="19" style="height:19px;width:276px;">Heat Therapy Pump, T/Pump</td>
			<td style="width:257px;">Gaymar Industries Inc</td>
			<td style="width:201px;">TP500-G89D19</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="19">
			<td height="19" style="height:19px;width:276px;">Infusion Pump 3000</td>
			<td style="width:257px;">SIMS Graseby LTD.</td>
			<td style="width:201px;">SN300050447</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="19">
			<td height="19" style="height:19px;width:276px;">Isoflurane Vapor 19.1</td>
			<td style="width:257px;">Draeger Medical Canada Inc.</td>
			<td style="width:201px;">N/A</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="19">
			<td height="19" style="height:19px;width:276px;">Monitor, Datex AS 3</td>
			<td style="width:257px;">Instrumentarium Corp./ Hitachi</td>
			<td style="width:201px;">D-VHC14-23-02</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="19">
			<td height="19" style="height:19px;width:276px;">Rotaflow Centrifugal Drive Unit</td>
			<td style="width:257px;">Marquet-Dynamed</td>
			<td align="right" style="width:201px;">952301</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="19">
			<td height="19" style="height:19px;width:276px;">Rotaflow Console</td>
			<td style="width:257px;">Marquet-Dynamed</td>
			<td align="right" style="width:201px;">706035</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="19">
			<td height="19" style="height:19px;width:276px;">Temperature Therapy Pad</td>
			<td style="width:257px;">Gaymar Industries Inc</td>
			<td style="width:201px;">TP26E</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="19">
			<td height="19" style="height:19px;width:276px;">Valleylab Force Tx</td>
			<td style="width:257px;">Valleylab Inc.</td>
			<td align="right" style="width:201px;">216151480</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="19">
			<td height="19" style="height:19px;width:276px;">Ventilator, AV 800</td>
			<td style="width:257px;">DRE Medical Equipment</td>
			<td style="width:201px;">40800AVV</td>
			<td style="width:240px;"></td>
		</tr>
		<tr height="19">
			<td height="19" style="height:19px;width:276px;">Warm Touch, Patient Warming System</td>
			<td style="width:257px;">Nellcor/ Covidien Canada</td>
			<td style="width:201px;">5015300A</td>
			<td style="width:240px;"></td>
		</tr>
	</tbody>
</table>

technique of porcine liver procurement and orthotopic transplantation using an active porto-caval shunt

The success of liver transplantation has resulted in a dramatic organ shortage. Each year, a considerable number of patients on the liver transplantation waiting list die without receiving an organ transplant or are delisted due to disease progression. Even after a successful transplantation, rejection and side effects of immunosuppression remain major concerns for graft survival and patient morbidity. 
Experimental animal research has been essential to the success of liver transplantation and still plays a pivotal role in the development of clinical transplantation practice. In particular, the porcine orthotopic liver transplantation model (OLTx) is optimal for clinically oriented research for its close resemblance to human size, anatomy, and physiology. 
Decompression of intestinal congestion during the anhepatic phase of porcine OLTx is important to guarantee reliable animal survival. The use of an active porto-caval-jugular shunt achieves excellent intestinal decompression. The system can be used for short-term as well as long-term survival experiments. The following protocol contains all technical information for a stable and reproducible liver transplantation model in pigs including post-operative animal care.

In einem ersten Transplantationsstudie einer Heart-Beating-Donor-Modell (HBD, n = 5) wurde mit einem DCD Modell (n = 10) bis 45 min warmer Ischämie in situ ausgesetzt verglichen. In beiden Gruppen wurden Transplantate auf Eis für 10 Stunden nach der Auftragsvergabe aufbewahrt. In der HBD-Gruppe 100% der Empfänger Schweine überlebten bis zum Ende des Follow-up am Tag 5 nach der Transplantation. In der DCD-Gruppe, nur 50% der Empfänger überlebte Schweine für 5 Tage durch Gerinnungsprobleme oder Stoffwechselentgleisung, als Folge der verminderten postoperativen Leberfunktion. Alle Blutproben wurden aus dem zentralen Venenkatheter gesammelt. Nach der Zentrifugation wurden Serumproben gewonnen und auf hepatozellulären Verletzung (Aspartataminotransferase, AST), Gallenfunktion (Gesamt-Bilirubin und alkalische Phosphatase), und die Leberfunktion (INR) analysiert. 5 - der zeitliche Verlauf eines jeden Markers in den 2 gezeigt ist. <p class="jove_content"&gt; AST-Werte erreichte ihren Höhepunkt nach 24 Stunden (1414 ± 538 U / L in der HBD-Gruppe und 2296 ± 1313 U / L in der DCD-Gruppe, p = 0,13) und nach 5 Tagen wieder auf fast normale Werte. In ähnlicher Weise wurden die alkalische Phosphatase-Werte deutlich nach 36 Stunden in der DCD-Gruppe (224 ± 111 U / l) im Vergleich zu der HBD Gruppe (162 ± 54 U / l, p = 0,27) erhöht. Während Gesamt-Bilirubin war in der HBD-Gruppe stabil (≤ 10 &amp; mgr; mol / L in), sie nach und nach in der DCD-Gruppe bis zum Tag 5 (23 ± 31 &amp; mgr; mol / l, p = 0,43) erhöht. Das große Standardabweichung in der Bilirubin-Werte im DCD-Gruppe zeigt eine eigentümliche Heterogenität Gallen Verletzungen in dieser Gruppe. INR als Marker der Leberfunktion zeigte einen Trend ähnlich dem AST-Werte. Werte erreichte 24 Stunden und wurden auf fast normale Werte nach 5 Tagen wieder hergestellt. Die HBD Gruppe hatten niedrigere Werte mit einem Peak bei 1,47 ± 0,34 im Vergleich zur Gruppe DCD (Peak 1,70 ± 0,36, p = 0,32). Abbildung 1. Schema der porto-Kava-Shunt jugular. Der Bypass ist mit Ringer-Lactat-Lösung gefüllt. Dann wird der Kava-Teil mit einer Schlauchklemme festgeklemmt ist, werden die Halsschlagader und der Milz Teile zu den voreingestellten Katheter angeschlossen ist, wird der Bypass geöffnet und die Kreiselpumpe nach Pfortader Klemm gestartet. Nach Leberresektion ist die Kava-Teil der Bypass eingelegt und in der infrahepatische Hohlvene Stumpf auf die Nierenvenen gesichert, Schädel. Die Schlauchklemme gelöst wird, um caval Dekompression zu ermöglichen, zusätzlich zu dem Portal Dekompression. <img alt="Figur 2" src="/files/ftp_upload/52055/52055fig2.jpg" /> Abbildung 2. Aspartat-Aminotransferase (AST) (HBD n = 5, DCD n = 10). AST ist ein empfindlicher Marker der Leberzellschädigung. Der Peak Achterner 24 Stunden in der HBD niedriger als in der DCD-Gruppe, was auf weniger Leber Reperfusionsschaden; die kleinere Standardabweichung zeigt homogenere Ergebnisse in der HBD-Gruppe. <img alt="Figur 3" src="/files/ftp_upload/52055/52055fig3.jpg" /> Abbildung 3. Gesamtbilirubin (HBD n = 5, DCD n = 10). Gesamtbilirubin, als Marker der biliäre Clearance und Gallen Integrität, eine stabile und homogene Trend mit Werten unter 10 &amp; mgr; mol / l in der HBD-Gruppe. Das Bilirubin Kurve im DCD Gruppe graduell über die Zeit und zeigt eine hohe Standardabweichung, was darauf hindeutet, Gallenschäden nur in einem Teil der Versuchsgruppe. <img alt="Figur 4" src="/files/ftp_upload/52055/52055fig4.jpg" /> Abbildung 4. Die alkalische Phosphatase (HBD n = 5, DCD n = 10). Die alkalische Phosphatase is einen Indikator für Gallen Verletzungen. Die Werte für die HBD-Gruppe sind niedriger als die der DCD-Gruppe, die weniger Gallen Verletzung impliziert. <img alt="Figur 5" src="/files/ftp_upload/52055/52055fig5.jpg" /> Abbildung 5. INR (HBD n = 5, DCD n = 10). Ein hoher Wert zeigt INR verminderten Leberfunktion aufgrund der verringerten Freisetzung von Gerinnungsfaktoren. In beiden HBD und DCD Gruppen, kehren die INR-Werte auf normale Werte von 5 Tagen nach der Transplantation, was darauf hindeutet Erholung der Leberfunktion. Die Werte für die HBD-Gruppe erscheinen niedriger.

Watch this Scientific Journal Video about Technique of Porcine Liver Procurement and Orthotopic Transplantation using an Active Porto-Caval Shunt at JoVE.com

Technique of Porcine Liver Procurement and Orthotopic Transplantation using an Active Porto-Caval Shunt

Experimental animal research plays a pivotal role in the development of clinical transplantation practice. The porcine orthotopic liver transplantation model (OLTx) closely resembles human conditions and is frequently used in clinically oriented research. The following protocol contains all information for a reliable porcine OLTx model using an active porto-caval-jugular shunt.

Technik der Schweineleber Beschaffung und orthotopen Transplantation mit einem Active Porto-Kava-Shunt

The success of liver transplantation has resulted in a dramatic organ shortage. Each year, a considerable number of patients on the liver transplantation ...

technique-porcine-liver-procurement-orthotopic-transplantation-using

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JoVE Journal

Medicine

16.3K Aufrufe.  Toronto General Hospital. Experimental animal research plays a pivotal role in the development of clinical transplantation practice. The porcine orthotopic liver transplantation model (OLTx) closely resembles human conditions and is frequently used in clinically oriented research. The following protocol contains all information for a reliable porcine OLTx model using an active porto-caval-jugular shunt.

Serie: Technique of Porcine Liver Procurement and Orthotopic Transplantation using an Active Porto-Caval Shunt

Orthotopic Liver Transplantation in Rats

Clinical progress in the field of liver transplantation has been largely supported by animal models1,2. Since the publication of the first orthotopic rat liver transplantation in 1979 by Kamada et al.3, this model has remained the gold standard despite various proposed alternative techniques4. Nevertheless, its broader use is limited by its steep learning curve5.
In this video paper, we show a simple and easy-to-establish revision of Kamada's two-cuff technique. The suprahepatic vena cava anastomosis is performed manually with a running suture, and the vena porta and infrahepatic vena cava anastomoses are performed utilizing a quick-linker cuff system6. Manufacturing the quick-linker kit is shown in a separate video paper.

We present an easy-to-establish revision of the classical two-cuff technique for orthotopic liver transplantation in rat.

Lebertransplantation bei der Ratte

Clinical progress in the field of liver transplantation has been largely supported by animal models1,2. Since the publication of the first orthotopic rat ...

Forschung

Medizin

Surgical Procedures for a Rat Model of Partial Orthotopic Liver Transplantation with Hepatic Arterial Reconstruction

Orthotopic liver transplantation (OLT) in rats using a whole or partial graft is an indispensable experimental model for transplantation research, such as studies on graft preservation and ischemia-reperfusion injury 1,2, immunological responses 3,4, hemodynamics 5,6, and small-for-size syndrome 7. The rat OLT is among the most difficult animal models in experimental surgery and demands advanced microsurgical skills that take a long time to learn. Consequently, the use of this model has been limited. Since the reliability and reproducibility of results are key components of the experiments in which such complex animal models are used, it is essential for surgeons who are involved in rat OLT to be trained in well-standardized and sophisticated procedures for this model.
While various techniques and modifications of OLT in rats have been reported 8 since the first model was described by Lee et al. 9 in 1973, the elimination of the hepatic arterial reconstruction 10 and the introduction of the cuff anastomosis technique by Kamada et al. 11 were a major advancement in this model, because they simplified the reconstruction procedures to a great degree. In the model by Kamada et al., the hepatic rearterialization was also eliminated. Since rats could survive without hepatic arterial flow after liver transplantation, there was considerable controversy over the value of hepatic arterialization. However, the physiological superiority of the arterialized model has been increasingly acknowledged, especially in terms of preserving the bile duct system 8,12 and the liver integrity 8,13,14.
In this article, we present detailed surgical procedures for a rat model of OLT with hepatic arterial reconstruction using a 50% partial graft after ex vivo liver resection. The reconstruction procedures for each vessel and the bile duct are performed by the following methods: a 7-0 polypropylene continuous suture for the supra- and infrahepatic vena cava; a cuff technique for the portal vein; and a stent technique for the hepatic artery and the bile duct.

Orthotopic liver transplantation in rats is an indispensable experimental model for biomedical research. Here we present our surgical procedures for orthotopic rat liver transplantation with hepatic arterial reconstruction using a 50% partial graft.

Chirurgische Verfahren für eine Ratte Modell Teilweise Lebertransplantation mit arteriellen Rekonstruktion

Orthotopic liver transplantation (OLT) in rats using a whole or partial graft is an indispensable experimental model for transplantation research, such as ...

Using the Sleeve Technique in a Mouse Model of Aortic Transplantation - An Instructional Video

Orthotopic aortic transplantation using the sleeve technique reduces injury to the aorta with failure rate of only 10-20%. The time to anastomose the aorta in mice using the sleeve method was short and easy averaging 20 min, permitting studies of iso/allo grafts. The following article describes the aortic transplantation procedure used in our laboratory. The mice were anesthetized with a mixture of 1.5% volume isoflurane and 100% oxygen through a face mask. At this point, the segment of the aorta between the renal arteries and its bifurcation was separated from the vena cava, freely prepared and clampedat the proximal and distal segments with a single silk suture. Prior to the removal of the aorta, a saline solution containing heparin was injected into the inferior vena cava. Then the aorta was cut between the clamps and a saline heparin solution was used to flush the lumen. The sleeve technique with monofilament sutures was used in order to transplant the abdominal aorta in the orthotopic position.

We present an orthotopic aortic transplantation model using the sleeve technique in mice. It is a very rapid anastomosis method, which can be employed in studies of vascular disease.

Mit Hilfe der Sleeve-Technik in einem Mausmodell der Aorta Transplantation - ein Lehr-Video

Orthotopic aortic transplantation using the sleeve technique reduces injury to the aorta with failure rate of only 10-20%. The time to anastomose the ...

A Rat Model of Orthotopic Liver Transplantation Using a Novel Magnetic Anastomosis Technique for Suprahepatic Vena Cava Reconstruction

The rat model of orthotopic liver transplantation (OLT) is essential for transplant research. It is a very sophisticated animal model and requires a steep learning curve. The introduction of the cuff technique for anastomosis of the portal vein (PV) and infrahepatic vena cava (IHVC) has significantly simplified the transplant procedure in rats. However, due to the short anterior wall of the recipients' suprahepatic vena cava (SHVC), the cuff technique is very difficult to use for the reconstruction of the SHVC. Most researchers in this field still use the hand-suture technique for SHVC reconstruction, which makes it the bottleneck step in rat orthotopic liver transplantation. The magnetic anastomosis technique (i.e., magnamosis) is a method of connecting two vessels using the attractive force between two magnets. Our recent study has shown that the magnetic anastomosis technique is superior to the hand-suture technique for SHVC reconstruction in rats. In this article, we show a step-by-step protocol for SHVC reconstruction in rats using the novel magnetic anastomosis technique. In this model, the reconstruction of the PV and IHVC was performed by the standard cuff technique, while the reconstruction of the bile duct (BD) was performed by a stent technique. The hepatic re-arterialization was not performed. The magnetic anastomosis technique made SHVC reconstruction much easier and significantly shortened the anphepatic phase. After a reasonable learning curve, even researchers without advanced microsurgical skills can produce reliable and reproducible results using this rat model of OLT.

The reconstruction of the suprahepatic vena cava (SHVC) remains a difficult step in rat orthotopic liver transplantation. In this article, we show a step-by-step protocol for SHVC reconstruction in rats using a novel magnetic anastomosis technique.

Einem Rattenmodell der orthotopen Lebertransplantation mit einer neuartigen magnetischen Anastomose-Technik für Suprahepatic Vena Cava Wiederaufbau

The rat model of orthotopic liver transplantation (OLT) is essential for transplant research. It is a very sophisticated animal model and requires a steep ...

A Pre-Clinical Porcine Model of Orthotopic Heart Transplantation

Fifty-years following the first successful report, cardiac transplantation remains the gold-standard treatment for eligible patients with advanced heart failure. Multiple small-animal models of heart transplantation have been used to study the acute and long-term effects of novel therapies. However, few are tested and demonstrated success in clinical trials. It is of critical importance to evaluate new therapies in a clinically relevant large-animal model for efficient and reliable translation of basic studies&#39;&#160;findings. Here, we describe a pre-clinical large-animal (porcine) model of orthotopic heart transplantation that has been firmly established and previously used to investigate novel cardioprotective strategies. This procedure focuses on acute ischemia-reperfusion injury and is a reliable method to investigate novel interventions which have been tested and validated in smaller experimental models, such as the murine model. We demonstrate its usefulness in assessing cardiac performance during the early post-transplantation period and other potential possibilities enabled by the model.

Here, we describe a pre-clinical large-animal (porcine) model of orthotopic heart transplantation that has been firmly established and utilized to investigate novel cardioprotective strategies.

Ein präklinisches Porcine-Modell der orthotopischen Herztransplantation

Fifty-years following the first successful report, cardiac transplantation remains the gold-standard treatment for eligible patients with advanced heart ...

Reduced Complications after Arterial Reconnection in a Rat Model of Orthotopic Liver Transplantation

The rat orthotopic liver transplantation (OLT) model is a powerful tool to study acute and chronic rejection. However, it is not a complete representation of human liver transplantation due to the absence of arterial reconnection. Described here is a modified transplantation procedure that includes the incorporation of hepatic artery (HA) reconnection, leading to a marked improvement in transplant outcomes. With a mean anhepatic time of 12 min and 14 s, HA reconnection results in improved perfusion of the transplanted liver and an increase in long-term recipient survival from 37.5% to 88.2%. This protocol includes the use of 3D-printed cuffs and holders to connect the portal vein and infrahepatic inferior vena cava. It can be implemented for studying multiple aspects of liver transplantation, from immune response and infection to technical aspects of the procedure. By incorporating a simple and practical method for arterial reconnection using a microvascular technique, this modified rat OLT protocol closely mimics aspects of human liver transplantation and will serve as a valuable and clinically relevant research model.

The goal of this study is to modify the rat orthotopic liver transplant model to better represent human liver transplantation and improve recipient survival. The presented method reestablishes hepatic arterial inflow by connecting the donor liver&#39;s common hepatic artery to the recipient liver&#39;s proper hepatic artery.

Reduzierte Komplikationen nach arterieller Wiederverbindung in einem Rattenmodell der orthotopischen Lebertransplantation

The rat orthotopic liver transplantation (OLT) model is a powerful tool to study acute and chronic rejection. However, it is not a complete representation ...

Orthotopic Kidney Auto-Transplantation in a Porcine Model Using 24 Hours Organ Preservation And Continuous Telemetry

In the present era of organ transplantation with critical organ shortage, various strategies are employed to expand the pool of available allografts for kidney transplantation (KT). Even though, the use of allografts from extended criteria donors (ECD) could partially ease the shortage of organ donors, ECD organs carry a potentially higher risk for inferior outcomes and postoperative complications. Dynamic organ preservation techniques, modulation of ischemia-reperfusion and preservation injury, and allograft therapies are in the spotlight of scientific interest in an effort to improve allograft utilization and patient outcomes in KT.
Preclinical animal experiments are playing an essential role in translational research, especially in the medical device and drug development. The major advantage of the porcine orthotopic auto-transplantation model over ex vivo or small animal studies lies within the surgical-anatomical and physiological similarities to the clinical setting. This allows the investigation of new therapeutic methods and techniques and ensures a facilitated clinical translation of the findings. This protocol provides a comprehensive and problem-oriented description of the porcine orthotopic kidney auto-transplantation model, using a preservation time of 24 hours and telemetry monitoring. The combination of sophisticated surgical techniques with highly standardized and state-of-the-art methods of anesthesia, animal housing, perioperative follow up, and monitoring ensure the reproducibility and success of this model.

Large animal models play an essential role in preclinical transplantation research. Due to its similarities to the clinical setup, the porcine model of orthotopic kidney auto-transplantation described in this article provides an excellent in vivo setting for the testing of organ preservation techniques and therapeutic interventions.

Orthotopische Nieren-Autotransplantation in einem Schweinemodell mit 24 Stunden Organkonservierung und kontinuierlicher Telemetrie

In the present era of organ transplantation with critical organ shortage, various strategies are employed to expand the pool of available allografts for ...

Left Lung Orthotopic Transplantation in a Juvenile Porcine Model for ESLP

Lung transplantation is the gold-standard treatment for end-stage lung disease, with over 4,600 lung transplantations performed worldwide annually. However, lung transplantation is limited by a shortage of available donor organs. As such, there is high waitlist mortality. Ex situ lung perfusion (ESLP) has increased donor lung utilization rates in some centers by 15%-20%. ESLP has been applied as a method to assess and recondition marginal donor lungs and has demonstrated acceptable short- and long-term outcomes following transplantation of extended criteria donor (ECD) lungs. Large animal (in vivo) transplantation models are required to validate ongoing in vitro research findings. Anatomic and physiologic differences between humans and pigs pose significant technical and anesthetic challenges. An easily reproducible transplant model would permit the&#160;in vivo&#160;validation of current ESLP strategies and the preclinical evaluation of various interventions designed to improve donor lung function. This protocol describes a porcine model of orthotopic left lung allotransplantation. This includes anesthetic and surgical techniques, a customized surgical checklist, troubleshooting, modifications, and the benefits and limitations of the approach.

This protocol describes a juvenile porcine model of orthotopic left lung allotransplantation designed for use with ESLP research. Focus is made on anesthetic and surgical techniques, as well as critical steps and troubleshooting.

Orthotope Transplantation der linken Lunge in einem juvenilen Schweinemodell für ESLP

Lung transplantation is the gold-standard treatment for end-stage lung disease, with over 4,600 lung transplantations performed worldwide annually. ...

Porcine Liver Transplantation Without Veno-Venous Bypass As an Extended Criteria Donor Model

Liver transplantation is regarded as the gold standard for the treatment of a variety of fatal hepatic diseases. However, unsolved issues of chronic graft failure, ongoing organ donor shortages, and the increased use of marginal grafts call for the improvement of current concepts, such as the implementation of organ machine perfusion. In order to evaluate new methods of graft reconditioning and modulation, translational models are required. With respect to anatomical and physiological similarities to humans and recent progress in the field of xenotransplantation, pigs have become the main large animal species used in transplantation models. After the initial introduction of a porcine orthotopic liver transplant model by Garnier et al. in 1965, several modifications have been published over the past 60 years.
Due to specifies-specific anatomical traits, a veno-venous bypass during the anhepatic phase is regarded as a necessity to reduce intestinal congestion and ischemia resulting in hemodynamic instability and perioperative mortality. However, the implementation of a bypass increases the technical and logistical complexity of the procedure. Furthermore, associated complications such as air embolism, hemorrhage, and the need for a simultaneous splenectomy have been reported previously.
In this protocol, we describe a model of porcine orthotopic liver transplantation without the use of a veno-venous bypass. The engraftment of donor livers after static cold storage of 20 h - simulating extended criteria donor conditions - demonstrates that this simplified approach can be performed without significant hemodynamic alterations or intraoperative mortality and with regular uptake of liver function (as defined by bile production and liver-specific CYP1A2 metabolism). The success of this approach is ensured by an optimized surgical technique and a sophisticated anesthesiologic volume and vasopressor management.
This model should be of special interest for workgroups focusing on the immediate postoperative course, ischemia-reperfusion injury, associated immunological mechanisms, and the reconditioning of extended criteria donor organs.

In this protocol, a model of porcine orthotopic liver transplantation after static cold storage of donor organs for 20 h without the use of a veno-venous bypass during engraftment is described. The approach uses a simplified surgical technique with minimization of the anhepatic phase and sophisticated volume and vasopressor management.

Schweinelebertransplantation ohne veno-venösen Bypass als erweitertes Kriterien-Spendermodell

Liver transplantation is regarded as the gold standard for the treatment of a variety of fatal hepatic diseases. However, unsolved issues of chronic graft ...

Quantitative Analyse der Lebersteifigkeitsverteilung

A Three-Dimensional Digital Model for Early Diagnosis of Hepatic Fibrosis Based on Magnetic Resonance Elastography

Hepatic fibrosis is an early stage of liver cirrhosis, and there are no better non-invasive and convenient methods for the detection and evaluation of the disease. Despite the good progress made with the liver stiffness map (LSM) based on magnetic resonance elastography (MRE), there are still some limitations that need to be overcome, including manual focus determination, manual selection of regions of interest (ROIs), and discontinuous LSM data without structural information, which makes it impossible to evaluate the liver as a whole. In this study, we propose a novel three-dimensional (3D) digital model for the early diagnosis of hepatic fibrosis based on MRE.
MRE is a non-invasive imaging technique that employs magnetic resonance imaging (MRI) to measure the liver stiffness at the scanning site through human-computer interaction. Studies have indicated a significant positive correlation between the LSM obtained through MRE and the degree of hepatic fibrosis. However, for clinical purposes, a comprehensive and precise quantification of the degree of hepatic fibrosis is necessary. To address this, the concept of Liver Stiffness Distribution (LSD) was proposed in this study, which refers to the 3D stiffness volume of each liver voxel obtained by the alignment of 3D liver tissue images and MRE indicators. This provides a more effective clinical tool for the diagnosis and treatment of hepatic fibrosis.

Autor im Rampenlicht: Fortschrittliche Leberfibrose-Diagnose mit Magnetresonanz-Elastographie und KI 

The objective of this study was to develop a novel three-dimensional digital model for the early diagnosis of hepatic fibrosis, which includes the stiffness of each voxel in the patient's liver and can thus, be used to calculate the distribution ratio of the patient's liver at different fibrosis stages.

Ein dreidimensionales digitales Modell zur Frühdiagnose von Leberfibrose auf Basis der Magnetresonanz-Elastographie

Hepatic fibrosis is an early stage of liver cirrhosis, and there are no better non-invasive and convenient methods for the detection and evaluation of the ...