that it was impossible to flush the catheter more frequently than 2-3 times a week (the animal 
had to be anesthetized each time) and it was impractical to completely restrain the animal from 
dislodging the catheter. We were able to flush and/or withdraw blood from the catheter for at 
least 7 days after the cell infusion suggesting that the catheter was in place and patent. By day 
10, however, we were unable to withdraw blood. On day 13 the animal was taken to the 
operating room where a laporotomy was performed. As suspected, the catheter was detached 
from the inferior mesenteric vein. There was no intra-abdominal gross pathology; the sites of 
partial hepatectomy and catheter insertion were well healed. An intraoperative portal 
venogram revealed a fully patent portal vein and intrahepatic portal branches without any 
evidence of intraluminal filling defects. The portal pressure was essentially identical to the 
pressure measured when the catheter was initially placed. A needle biopsy of the liver was 
taken. No histopathology was noted. 
The postoperative course of this animal has been unremarkable. Extensive analysis of 
blood chemistries and hematologies revealed no abnormalities except for a minor and transient 
increase in liver function tests immediately after partial hepatectomy (Table 4). 
The operative note from the partial hepatectomy, tube placement and cell infusion is 
provided below. 
.QO-Note on partial h e patectom y a nd catheter p lacement (8/19/91); 
Anesthesia- Ketamine and atropine. Intubated without difficulty. 
Prep- Shaved over abdomen and left shoulder blade. Position for Hickman 
marked by placing B206 into vest. Tied flat with sterile dressings underneath to allow 
catheter placement. Prepped with Betadine spray. 
Operation- Left subcostal incision, well muscled; more difficult to go through the 
rectus with no muscle relaxant. Peritoneal cavity entered and adhesions to anterior 
abdominal wall encountered. Triangular ligamentous attachments to the left lobe were 
identified and divided with the cautery back to the vascular pedicle. A medium Satinsky 
was placed across the pedicle and clamped. The clamp was placed very carefully to avoid 
encroachment on the remaining hepatic veins. The liver was transected and a centimeter 
of tissue was left. Blood loss was minimal. An O vicryl on an SH needle was used to 
transfix the vascular pedicle just under the clamp. The liver remnant was trimmed 
carefully so as not to cut the suture. The adhesions to the anterior abdominal wall were 
divided and the inferior mesenteric vein was identified. Overlying peritoneum and small 
branches were divided. The vein was dissected for about 1.5 cm. Two 3-0 silks were 
used to occlude the vein. Next, the tunnel to the posterior scapular region was made by 
rolling B206 onto its right side and making a skin incision. The tunnel was made and the 
catheter was pulled through so that the Dacron cuff was about 2 cm beneath the skin. The 
catheter was brought through the abdominal wall lateral to the rectus and tailored to 
size. A partial transection of the IMV was made with about 5 ml blood loss due to getting 
the catheter into the vessel. It was necessary to get suction. The catheter was tied in the 
vein so that about 2 cm remained in the vessel. Good blood return was seen in a syringe 
of heparinized saline (saline containing 1-10 u/ml). The fascia was closed in two 
layers with 0 vicryl running and the skin was closed with staples. Sterile furacin spray 
and dressings were applied. The catheter was secured with a 3-0 nylon suture. The vest 
was applied and the baboon was allowed to recover in its cage. 
Op Note on cell infusion (8/22/91); 
Animal sedated and intubated and transported to fluoroscopy suite. Placed on 
fluoroscopy table and the catheter was irrigated. Good blood flash. 27cc of Conray 60 
was then used to shoot two films. The first was underpenetrated. Half of the cell infusate 
Recombinant DNA Research, Volume 15 
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