Current Topics in TransplantationExperimental studiesIsoflurane: An Ideal Anesthetic for Rodent Orthotopic Liver Transplantation Surgery?

•We compared different anesthetics in mouse OLT.•ISO should be the preferred anesthetic for mouse OLT.•KET and CHL are also effective as donor anesthetics.•PEN is hepatotoxic and should be avoided during mouse OLT.

PurposeBecause the choice of anesthetic affects the rodent orthotopic liver transplantation (OLT) model, we compared the effects of isoflurane, ketamine, chloral hydrate, and pentobarbital on the OLT model.Basic ProceduresOLT was performed using the two-cuff technique. Two hundred male rats were randomly divided into five groups: control, isoflurane, ketamine, chloral hydrate, and pentobarbital groups. Rectal temperatures, respiratory rates, arterial blood values (pH, PaCO2, PaO2, and SatO2), liver function tests and histopathology, recovery times, and anhepatic stage mortality rates were assessed.Main FindingsCompared with controls, respiratory rates decreased by 20% in the isoflurane group, and decreased by 40%-50% in the ketamine, chloral hydrate, and pentobarbital groups. The PaO2, SatO2, and pH levels in the ketamine, chloral hydrate, and pentobarbital groups were significantly lower than those in the isoflurane and control groups (P < .05). Only the pentobarbital group displayed significant liver histopathologic changes along with significantly higher levels of serum alanine aminotransferase and total bilirubin, but a significantly lower level of serum albumin, compared with the control group (P < .05). The isoflurane group had a 0% anhepatic stage mortality rate compared with rates of 30%-40% in the other anesthetic groups.Principal ConclusionsIsoflurane should be the preferred anesthetic for rodent OLT surgery due to its minimal respiratory and hepatic physiological effects as well as its low anhepatic phase mortality rate. Secondary to isoflurane, ketamine and chloral hydrate may be administered as donor anesthetics. Pentobarbital use should be avoided entirely in rodent OLT surgery due to its significant hepatotoxic effects.