Assessment of remnant liver function and volume after selective ligation of portal vein and hepatic artery in a rat model

Abreu, Thiago Boechat de; Ribeiro, Alexandre de Abreu; Provenzano, Lívia Paola Colchete; Filho, Joaquim Ribeiro; Schanaider, Alberto

doi:10.1590/s0102-865020190110000003

Cited by 2 publications

(1 citation statement)

References 30 publications

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“…Larger hepatectomies with small remnants are complex surgeries in which it is necessary to associate adequate margins with a parenchyma capable of hypertrophy [21]. Searching for mechanisms in experimental models that provide greater hypertrophy in the remnant liver is one of the ways to increase the indications for surgery in previously inoperable patients [22].…”

Section: Discussionmentioning

confidence: 99%

Effects of Portal Preconditioning In Low-Volume Liver Remnants: Study In Rats

Ribeiro

Takiya

Pannain

et al. 2021

Preprint

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The increase of liver surgical indications, the expansion of the margins in hepatic resections and the lack of organ donors led to the use of more split livers from cadaver and living donors and smaller liver remnants in post-operatory patients. The use of increasingly smaller grafts associated with hepatic resections broadened the spectrum for observation of small-for size syndrome, caused by significant inflammation and early hepatic fibrosis. The small-for-size syndrome is manifested clinically by prolonged cholestasis, refractory ascites and progressive hepatic dysfunction (encephalopathy and coagulopathy). In the search for mechanisms to reduce liver damage, preconditioning is presented as a possibility of protecting the low weight remnant in experimental works. Objective: Study the hepatic tissue measuring the impact of portal preconditioning in small hepatic remnant in Wistar rats Methods: Rats weighing approximately 250g were divided in 4 groups with 7 members each. Group 1, Control group requiring only collection of the material, blood laboratory analysis and liver biopsy for pathology and immunohistochemistry; Group 2, Sham, were operated with simple laparotomy, 48 hours later they were subjected to another surgery with sample collection to do blood laboratory analysis and liver biopsy for pathology and immunohistochemistry. Group 3, hepatectomy with preconditioning. In this group was made the preconditioning procedure before the resection of 70% of the liver, 48 hours later they underwent another surgery for sample collection to do blood laboratory analysis and liver biopsy for pathology and immunohistochemistry. Group 4, hepatectomy without preconditioning. In this group the members were operated with resection of 70% of the liver, 48 hours later were reoperated with sample collection to do blood laboratory analysis and liver biopsy for pathology and immunohistochemistry. We studied and compared the impacts in morphology, laboratory, histology, immunohistochemistry.Results: There was no intraoperative mortality in the model used, there was no statistically significant difference in histological and laboratory parameters between the groups with and without preconditioning, there was an increase in the expression of PCNA with statistical significance in the hepatic remnant of the group submitted to preconditioning. Conclusion: Liver preconditioning can provide an increase in cell proliferation in small volume liver remnant.

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Section: Discussionmentioning

confidence: 99%

Effects of Portal Preconditioning In Low-Volume Liver Remnants: Study In Rats

Ribeiro

Takiya

Pannain

et al. 2021

Preprint

Self Cite

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Efficacy of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) in hepatocellular carcinoma with macrovascular invasion: a single-center retrospective analysis

Ye,

Ou,

Wen

et al. 2024

World J Surg Onc

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Objective The influence of macrovascular invasion on the therapeutic efficacy of Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy (ALPPS) in hepatocellular carcinoma (HCC) patients has not been previously reported. This study primarily examines the therapeutic effect of ALPPS in treating HCC with macrovascular invasion. Methods 89 patients who underwent ALPPS at the First Affiliated Hospital of Guangxi Medical University from December 2016 to December 2021 were included. Patients were categorized into three groups based on macrovascular invasion status: pure HCC, HCC with portal vein tumor thrombus (PVTT), and HCC with hepatic vein tumor thrombus (HVTT). Outcome measures such as postoperative complications, liver hyperplasia rates, and survival times were compared across the groups. Results The study comprised 44 patients without macrovascular invasion and 45 cases with it, including 37 PVTT and 8 HVTT cases. Patients with PVTT or HVTT had a higher rate of complications and liver failure after the first ALPPS stage compared to those without macrovascular invasion ( P = 0.018, P = 0.036). This trend was also observed in the stratified analysis of severe complications. However, no significant differences were found in these outcomes after the second ALPPS stage among the groups. The volume and rate of future liver remnant proliferation between the two stages of ALPPS were not statistically different among the groups, with median overall survival times of 42, 39, and 33 months, and progression-free survival times of 30, 24, and 14 months, respectively ( P = 0.412 and P = 0.281). Conclusion ALPPS for HCC with macrovascular invasion was considered safe, feasible, and effective, as it achieved therapeutic effects comparable to those in cases without macrovascular invasion.

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Assessment of remnant liver function and volume after selective ligation of portal vein and hepatic artery in a rat model

Cited by 2 publications

References 30 publications

Effects of Portal Preconditioning In Low-Volume Liver Remnants: Study In Rats

Effects of Portal Preconditioning In Low-Volume Liver Remnants: Study In Rats

Efficacy of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) in hepatocellular carcinoma with macrovascular invasion: a single-center retrospective analysis

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