Establishing a Porcine Model of Small for Size Syndrome following Liver Resection

Abstract

Background Small for size syndrome (SFSS) is responsible for a high proportion of mortalities and morbidities following extended liver resection. Aim The aim of this study was to establish a porcine model of SFSS. Methods Twenty-four Landrace pigs underwent liver resection with a remnant liver volume of 50% (group A, n = 8), 25% (group B, n = 8), and 15% (group C, n = 8). After resection, the animals were followed up for 8 days and clinical, laboratory, and histopathological outcomes were evaluated. Results The survival rate was significantly lower in group C compared with the other groups (p < 0.001). The international normalized ratio, bilirubin, aspartate transaminase, alanine transaminase, and alkaline phosphatase levels increased shortly after surgery in groups B and C, but no change was observed in group A (p < 0.05 for all analyses). The histopathological findings in group A were mainly mild mitoses, in group B severe mitoses and hepatocyte ballooning, moderate congestion, and hemorrhage, along with mild necrosis, and in group C extended tissue damage with severe necrosis, hemorrhage, and congestion. Conclusions Combination of clinical, laboratory, and histopathological evaluations is needed to confirm the diagnosis of SFSS. 75% liver resection in porcine model results in SFSS. 85% liver resection causes irreversible liver failure.

Porcine model for the study of liver regeneration enhanced by non-invasive 13C-methacetin breath test (LiMAx test) and permanent portal venous access

“…The aim of our established animal model was to generate all symptoms of decreased liver function following major liver resection without the risk of high mortality close to the clinical reality. There are several other studies of partial liver resection and consequent PHLF [37–40]. In contrast to our study, most of these published models recommend a FLR of only 10–35% which results in high a mortality [37, 38].…”

“…There are several other studies of partial liver resection and consequent PHLF [37–40]. In contrast to our study, most of these published models recommend a FLR of only 10–35% which results in high a mortality [37, 38]. Especially the resection of 90% of the liver parenchyma will surely result in fatal liver failure rather than establishment of a regenerative milieu.…”

Histopathological effects of modern topical sealants on the liver surface after hepatectomy: an experimental swine study

“…To address this, we investigated histopathological changes to the liver resection surface after application of two different sealants (CBS and FBS). We used a swine model because the pig liver is similar in size and anatomy to the human liver and provides a greater scope for surgical evaluation compared with small animal models 22 . We compared the histopathological changes in sealant groups with two different control groups.…”

Comment on “Establishing a Porcine Model of Small for Size Syndrome following Liver Resection”

“…We read with great interest the article by Golriz et al [ 1 ] published in the August 2017 issue of Canadian Journal of Gastroenterology and Hepatology. The aim of this research study was to establish a porcine model of small for size syndrome (SFSS).…”

“…The histological evaluation of hepatocyte proliferation in the 3 groups by measuring Ki-67 proliferative index and nuclear factor kappa-beta expression should be really interesting. By doing so, Golriz et al should be able to evaluate more accurately the liver regeneration among the 3 groups [ 1 ].…”