Fetal Pig Liver Transplant

Stomach: breaks down food

Diaphragm: Muscle that contracts to create negative pressure in the thoratic cavity

Pancreas: produces and secretes digestive enzymes, these go into the duodenum of the small intestine

Small intestine: Digestion; absorption of nutrients

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Fetal Pig Liver Transplant

Family medical history

Peter the Pig’s Father was a domesticated American Yorkshire who died at the age of 7 years. Weighing in at 420 lbs. he suffered from osteoarthritis (OA) in his knees which resulted in two hind leg fractures and caused him to be put down.

Peter’s mother, also an American Yorkshire sow, died at the age of 6 at a weight of 360 lbs. She suffered from Hepatitis C which ultimately resulted in Cirrhosis.

Lifestyle choices

Peter had acquired a taste for alcohol, while in the womb

By Alexis Deriberprey & Ingrid Martinez

Enzymes

What are the functions/location of the liver?

Surgical Procedure

Patient: Peter the Pig

Organs

• Position him lying on his back
• Make an incision under the ribs on both sides of the abdomen
• Separate the diseased liver from the surrounding organs by cutting it off from the blood vessels
• The new liver will be then attached to the blood vessels
• The new liver will be connected to the bile ducts
• Close incision

Soon after birth, patient Peter the Pig exhibited both nausea and vomiting once he began suckling his mother’s tits. Peter also refused to eat for the next several hours, an unusual instance for this species who consumer food very frequently. Once brought in and examined, he had developed a jaundice color of the eyes and his light pink skin had become a murky tan.

Physical exam

Normal Range per Liter of Serum (liquid portion of blood):

- AST 5-40 units

- ALT 7-56 units

The liver is the largest internal organ. The structure is located in the cranial portion of the abdomen, typically centered right of the midline and situated above the stomach and intestines. The liver of swine is made up of four lobes which are broken down into fissures.

Spleen: Part of the immune system; filters out and destroys dead blood cells

Gall bladder: Stores bile salts produced by the liver.

Post Op (long term)

What enzymes are produced by the liver?

The long term expectation for our patient is for his body to successfully accept the new liver and prevent infection. For the rest of his life, he would need to be on medications in order to fight rejection. Some symptoms of rejection include:

• Fever
• Jaundice
• Dark urine
• Itching
• Abdominal swelling
• Fatigue
• Headache
• Nausea

Vital signs:

Rectum Temperature- 102oF

HBP- 70 per minute

Respiratory Rate- 16 breaths per minute

Weight- 2.9 lbs

Age- 100 days

Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) are the most abundant enzymes in liver cells and are known as the transaminases. AST is found in heart, liver, kidney, brain, and muscle tissues so its presence in the blood stream is not a positive indicator of a liver disease as any of these tissues could be damaged. ALT on the other hand is more indicative of a liver disease or injury as it is predominantly concentrated in the liver.

Alkaline phosphatase (AP) and gammaglutamyl transferase (GGT) are called cholestatic liver enzymes. AP and GGT are indicative of bile duct injuries if the enzymes are elevated.

Post Op (short term)

After the surgery, we must take him to the ICU and monitor his EKG tracing, blood pressure, breathing rate and oxygen level to make sure they are under control. If all is well, he should be able to go home in about 7-14 days.

The liver provides many critical functions for life including the production of bile. Bile aids in the emulsification of lipids and assists in eliminating waste products. Almost all blood which circulates throughout the abdomen flows through the liver which essentially detoxifies the blood by breaking down hemoglobin and toxic substances. Also regulates blood clotting, removes foreign agents from the bloodstream, and oxygen transportation.

Diagnostic Tests

A blood analysis test showed that Peter tested positive for Hepatitis C.

His transaminase levels were 8 times the upper limit.

Diagnosis?

Cirrhosis