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Allogeneic Venous Grafts of Different Origin Used for Portal Vein Reconstruction After Pancreaticoduodenectomy - Experimental Study

R. Palek, A. Jonasova, J. Rosendorf, P. Mik, K. Bajcurova, P. Hosek, V. Moulisova, L. Eberlova, L. Haidingerova, O. Brzon, L. Bednar, T. Kriz, M. Dolansky, V. Treska, Z. Tonar, J. Vimmr, V. Liska,

. 2019 ; 39 (12) : 6603-6620. [pub] -

Language English Country Greece

Document type Comparative Study, Journal Article

Persistent link   https://www.medvik.cz/link/bmc19044450

BACKGROUND: In clinical medicine, little is known about the use of allografts for portal vein (PV) reconstruction after pancreaticoduodenectomy (PD). Portal and caval systems are physiologically different, therefore the properties of allografts from caval and portal systems were studied here in a pig model. MATERIALS AND METHODS: PD with PV reconstruction with allogeneic venous graft from PV or inferior vena cava (IVC) was performed in 26 pigs. Biochemical analysis and ultrasonography measurements were performed during a 4-week monitoring period. Computer simulations were used to evaluate haemodynamics in reconstructed PV and explanted allografts were histologically examined. RESULTS: The native PV and IVC grafts varied in histological structure but were able to adapt morphologically after transplantation. Computer simulation suggested PV grafts to be more susceptible to thrombosis development. Thrombosis of reconstructed PV occurred in four out of five cases in PV group. CONCLUSION: This study supports the use of allografts from caval system for PV reconstruction in clinical medicine when needed.

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$a BACKGROUND: In clinical medicine, little is known about the use of allografts for portal vein (PV) reconstruction after pancreaticoduodenectomy (PD). Portal and caval systems are physiologically different, therefore the properties of allografts from caval and portal systems were studied here in a pig model. MATERIALS AND METHODS: PD with PV reconstruction with allogeneic venous graft from PV or inferior vena cava (IVC) was performed in 26 pigs. Biochemical analysis and ultrasonography measurements were performed during a 4-week monitoring period. Computer simulations were used to evaluate haemodynamics in reconstructed PV and explanted allografts were histologically examined. RESULTS: The native PV and IVC grafts varied in histological structure but were able to adapt morphologically after transplantation. Computer simulation suggested PV grafts to be more susceptible to thrombosis development. Thrombosis of reconstructed PV occurred in four out of five cases in PV group. CONCLUSION: This study supports the use of allografts from caval system for PV reconstruction in clinical medicine when needed.
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$a Jonasova, Alena $u Department of Mechanics, Faculty of Applied Sciences, University of West Bohemia, Pilsen, Czech Republic.
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$a Mik, Patrik $u Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic. Department of Anatomy, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic.
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$a Bajcurova, Kristyna $u Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic. Department of Medical Imaging, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic.
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$a Haidingerova, Lenka $u Department of Anesthesiology and Resuscitation, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic.
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$a Vimmr, Jan $u Department of Mechanics, Faculty of Applied Sciences, University of West Bohemia, Pilsen, Czech Republic.
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$a Liska, Vaclav $u Department of Surgery, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic palekrichard@gmail.com vena.liska@skaut.cz. Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic.
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