Effect of the Portacaval Shunt on Reperfusion Injury after 65% Hepatectomy in Pigs

• Published in: European surgical research Vol. 40; no. 4; pp. 347 - 353
• Main Authors: Farantos, C., Arkadopoulos, N., Theodoraki, K., Kostopanagiotou, G., Katis, K., Tzavara, K., Andreadou, I., Dimopoulou, K., Hatzoudi, E., Sidiropoulou, T., Skalkidis, I., Paphiti, A., Smyrniotis, V.
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland S. Karger AG 01.01.2008
• Subjects: Animals; Hepatectomy - adverse effects; Liver - pathology; Original Paper; Portacaval Shunt, Surgical; Random Allocation; Reperfusion Injury - blood; Reperfusion Injury - pathology; Reperfusion Injury - prevention & control; Swine; Warm Ischemia - adverse effects; Pigs; Portal blood flow; Ischemia/reperfusion; Liver regeneration; Apoptosis; Hepatectomy
• ISSN: 0014-312X; 1421-9921
• DOI: 10.1159/000118031

Background: Portal flow diversion by portacaval shunts (PCS) has been shown to prevent primary graft nonfunction in liver transplantation using small-for-size grafts. In this study, we examine whether PCS can improve reperfusion injury after major hepatectomy in pigs. Materials and Methods: In 14 pigs, a partial PCS was constructed following 65% hepatectomy and 1 h of inflow ischemia. During 24 h of reperfusion, the shunt was either closed (group A, n = 7) or left open (group B, n = 7). Results: 24 h after reperfusion, group A had higher levels of alanine aminotransferase (70 ± 12 IU/l vs. 51 ± 5.9 IU/l; p < 0.05), alanine aminotransferase per gram of liver remnant (0.41 ± 0.07 IU/l/g vs. 0.21 ± 0.05 IU/l/g; p < 0.05), prothrombin time (24.1 ± 2.4 s vs. 14.3 ± 2.9 s; p < 0.05), international normalized ratio (2.11 ± 0.15 vs. 1.29 ± 0.28; p < 0.05), hepatocyte necrosis scores and percentages of nuclei stained for proliferating cell nuclear antigen (52.57 ± 8.9% vs. 36.71 ± 6%; p < 0.05) compared to group B. Conclusions: Partial portal flow diversion appears to attenuate reperfusion injury in a porcine model of major hepatectomy.