Quantitative Assessment of Liver Function after Ischemia-Reperfusion Injury and Partial Hepatectomy in Rats

• Published in: The Journal of surgical research Vol. 172; no. 1; pp. 85 - 94
• Main Authors: de Graaf, Wilmar, M.D., Ph.D, Heger, Michal, Ph.D, Spruijt, Onno, M.S, Maas, Adrie, B.S, de Bruin, Kora, B.S, Hoekstra, Ruurdtje, Ph.D, Bennink, Roelof J., M.D., Ph.D, van Gulik, Thomas M., M.D., Ph.D
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 2012
• Subjects: 99mTc-mebrofenin; Animals; Bilirubin - metabolism; Hepatectomy; hepatobiliary scintigraphy; Hepatocytes - pathology; indocyanine green; Indocyanine Green - metabolism; ischemia reperfusion; Liver - metabolism; Liver - physiopathology; Liver - surgery; Liver Function Tests; liver regeneration; Liver Regeneration - physiology; liver uptake and clearance; Male; Models, Animal; Prothrombin Time; Radionuclide Imaging; Rats; Rats, Wistar; Reperfusion Injury - complications; Reperfusion Injury - pathology; Reperfusion Injury - physiopathology; Surgery; ischemia reperfusion; 99mTc-mebrofenin; liver regeneration; liver uptake and clearance; indocyanine green; hepatobiliary scintigraphy
• ISSN: 0022-4804; 1095-8673
• DOI: 10.1016/j.jss.2010.06.038

Background Liver function after hepatic ischemia-reperfusion (I/R) injury and partial liver resection (PHx) is influenced by the extent of PHx, hepatocellular damage, and liver regeneration. This study investigates the effect of minor PHx with increasing degrees of I/R-induced damage on postoperative liver function parameters and compares the indocyanine green (ICG) clearance test with99m Tc-mebrofenin hepatobiliary scintigraphy (HBS) for quantitative measurement of hepatic function in a standardized rat model. Methods Rats were subjected to 70% partial liver I/R combined with resection of the nonischemic lobes. Various degrees of hepatic damage were induced by 0, 15, 30, 45, and 60 min ischemia. Prothrombin time and bilirubin were used as indirect parameters of liver function.99m Tc-mebrofenin HBS and ICG clearance were used as dynamic quantitative liver function tests. Results After 24 h reperfusion hepatocellular damage increased with prolonged ischemia times. Hepatocellular damage and liver regeneration were closely interrelated. Moderate I/R-induced damage enhanced regeneration, while extensive damage debilitates the regenerative capacity. PHx alone resulted in no significant decrease in liver uptake function measured by HBS or ICG. Increasing severity of hepatic I/R injury had a differential effect on ICG clearance and99m Tc-mebrofenin uptake and excretion. Conclusions The specific impact of 30% PHx combined with progressive ischemia times is different for each liver function test. Albeit99m Tc-mebrofenin HBS and the ICG clearance test provide complementary quantitative information to biochemical parameters, they only quantify one or two components of liver function. ICG and99m Tc-mebrofenin uptake profiles differed significantly, suggesting that the specific hepatic transporters may be distinct.