Evidence that host size determines liver size: Studies in dogs receiving orthotopic liver transplants
✍ Scribed by Igal Kam; Steven Lynch; Gregory Svanas; Satori Todo; Lorenzo Polimeno; Antonio Francavilla; Ronald J. Penkrot; Sunichi Takaya; Bo G. Ericzon; Thomas E. Starzl; David H. Van Thiel
- Book ID
- 102848369
- Publisher
- John Wiley and Sons
- Year
- 1987
- Tongue
- English
- Weight
- 550 KB
- Volume
- 7
- Category
- Article
- ISSN
- 0270-9139
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✦ Synopsis
Orthotopic liver transplantation was performed in two groups of dogs; Group I animals consisted of large dogs that served as recipients of livers obtained from smaller dogs while Group 11 animals consisted of dogs that received liver from donor dogs of nearly the same size. The small-for-size livers transplanted into the Group I dogs rapidly increased in size over the course of 2 weeks until they achieved a size equal to that originally present in the larger recipient dogs. In contrast, the livers transplanted into dogs of the same size as the donors underwent some degree of atrophy. In both groups of animals, plasma levels of insulin and glucagon and hepatic (graft) activities of thymidine kinase and ornithine decarboxylase were followed serially. The only difference between the two groups of animals for these measures was that the ornithine decarboxylase activity rose to a greater degree in the liver that underwent graft enlargement. These data suggest that recipient size determines, at least in part, liver graft size once it is transplanted. These data also suggest that of the parameters followed, only ornithine decarboxylase activity parallels the finding of growth of the transplanted liver.
Occasionally, in clinical liver transplantation, a liver from a small donor is transplanted into a much larger recipient because of urgent need and inability of the transplanting surgeons t o identify a more appropriate donor. In such cases, we have noted that the intact transplanted organ rapidly increases in size to achieve a size comparable to t h a t of a normal liver within a normal individual of the size and age as the recipient over a period of 2 weeks (1). To investigate the mechanisms responsible for this phenomenon, the following studies were performed.
Methods
Animcrls. Orthotopic liver transplantation (OLTx) was performed in two groups of young adult mongrel dogs using a modification of the procedure originally described by Starzl et ~~ ~