ABSTRACT
Multiple organ grafts have been done in the past using the following technique: a common single vascular pedicle is anastomosed to the host’s vessels supplying two grafts, such as spleen and pancreas,1 or multiple grafts such as liver, spleen, pancreas, and duodenum. This chapter gives a detailed report of authors' surgical technique used in this animal model, and reports on a specific application of this technique. When the anastomoses are completed, the clamp is removed, opening the blood supply to all grafted organs simultaneously. The technique works equally well with any organ grafted. The simultaneous transplantation of multiple organs leads to immediate expansion of the vascular bed. Once the heart and its corresponding spleen are implanted, both organs have to be alternately overturned, i.e., “flip-flopped” in order to give enough room for the anastomoses of the third organ. Autopsy showed characteristic swelling of all three grafted organs with minimal or no blood flow through the various vascular pedicles.
