We describe the design of the “quick-linker” device for easier orthotopic rat liver transplantation.
Orthotopic rat liver transplantation is a popular model, which has been shown in a recent JoVE paper with the use of the “quick-linker” device. This technique allows for easier venous cuff-anatomoses after a reasonable learning curve. The device is composed of two handles, which are carved out from scalpel blades, one approximator, which is obtained by modifying Kocher’s forceps, and cuffs designed from fine-bore polyethylene tubing. The whole process can be performed at a low-cost using common laboratory material. The present report provides a step-by-step protocol for the design of the required pieces and includes stencils.
A technique of orthotopic rat liver transplantation has been shown in a recent Journal of Visualized Experiments paper 1. Portal vein and infra-hepatic vena cava anastomoses were performed using the quick-linker assisted cuff technique. This technique was chosen among other revisions of the original Kamada’s technique 2-4, as it allows for easier and quicker anastomoses, results in a better hemodynamic, and can be implemented with a shorter learning curve 1,5.
The quick-linker technique requires the use of a handle, an approximator and cuffs, all of which can be designed from common laboratory material according to the technique described in the present report.
1. Handle: Design and Shaping
2. Approximator: Design and Shaping
3. Cuffs: Design and Shaping
Five kits, including five approximators and 11 handles have been manufactured. One handle broke during the final brushing. This problem was due to the fact that the ring of the handle was too narrow, and it has been solved by setting the narrowest part of the handle ring at 0.5 mm. No problems occurred during the shaping of the approximators.
Rat weight (g) | Porta handle (inner dia) (mm) | Porta cuff (outer dia) (mm) | IVC handle (inner dia) (mm) | IVC cuff (outer dia) (mm) |
120-180 | 2.2 | 1.7 | 2.6 | 2.08 |
180-270 | 2.6 | 2.08 | 3.4-3.7 | 3.0-3.25 |
>270 | 2.9 | 2.42 | 4.2 | 3.7 |
Table 1.
Figure 1. Porta handle stencil. If printed with a scale 1:1 can be used to guide the handle shaping. Click here to view larger figure.
Figure 2. IVC handle stencil. If printed with a scale 1:1 can be used to guide the handle shaping. Click here to view larger figure.
Figure 3. Porta and IVC cuffs lateral view. Graft’s v.porta should be secured to the central groove, while recipient’s vessel to the lateral one. This expedient allows for optimal intima-to-intima contact.
Figure 4. Porta and IVC cuffs front view. Calipers suitable for rats weighing 180-270 g are represented.
The present report describes the design and building of the quick-linker system for easier rat liver transplantation.
Rat liver transplantation is a popular model with 125 to 180 related papers published yearly since the early 1990’s (www.pubmed.com). It allows for a wide range of experiments including the exploration of immunological and graft preservation issues. The use of the “quick-linker” kit allows for easier and quicker anastomoses with guaranteed intima-to-intima contact. A detailed description and discussion of the technical steps of a rat liver transplantation have been described previously 1.
The quick-linker kit can be built at low price from common laboratory material. The main challenge encountered has been related the breakdown of one handle during the final brushing, and that problem has been solved by setting the narrowest part of the handle ring at 0.5 mm (Figures 1 and 2 show appropriate sizes). Regarding the blade quality, only stainless steel should be considered. Although slightly less flexible compared to the average carbon steel blade, stainless steel blades do not develop rust, allowing a lifetime use of the handles.
Of note, the design of the current handles and cuffs is the result of a process, which has led to the proposed sizes, allowing for the most efficient anastomoses. Cuff diameters vary according to the rat weights (Table 1). Minimal variations can be tolerated in terms of length, with a usual length of about 4 mm (Figures 3 and 4).
Regarding the approximator, the selected Kocher’s forcep should have handles at least 4 cm from the fulcrum. This allows for a safe closure of the rack outside the animal’s abdomen.
Overall, the proposed device can allow easier vein anastomoses for the transplantation of liver and other types of grafts in rats.
The authors have nothing to disclose.
The study was supported by the Artères Foundation, the Astellas Foundation Europe and the Boninchi Foundation. CT was supported by the Swiss National Science Foundation (SCORE grant 3232230-126233).
Tool / Reagent | Company | Catalogue n. | Comment |
Porta cuff | altecweb or smiths-medical | Coil 01-96-1729 800/100/420 |
Bore : variable Wall : 0.30 mm Length: 3.8-4.2 mm altecweb.com or smiths-medical.com |
IVC cuff | altecweb or smiths-medical | Coil 01-96-1733 800/100/540 |
Bore : variable Wall : 0.30 mm Length: 3.8-4.2 mm altecweb.com or smiths-medical.com |
Mini-drill | Dremel | 100 series | 35,000 rpm dremel.com |
Diamond wheel point | Dremel | 7103 | 2 mm dremel.com |
Diamond wheel point | Dremel | 7105 | 4.4 mm dremel.com |
Diamond wheel point | Dremel | 7144 | 2.4 mm dremel.com |
Cut-off wheels | Dremel | 420 | dia: 23.8 mm thickness: 0.5 mm dremel.com |
Quick-linker handles | dltchiropody (DLT) | PAR 10 | modified scalpel blades dltchriopdy |
Quick-linker approximator | pharmap | UD-04-275 | modified Kocher’s forceps pharmap.ch |