Excessive bleeding at hepatic resection after experimental liver denervation

Kullendorff, Carl‐Magnus; Zoucas, Evita; Lindfeldt, J.; Holmin, T.

doi:10.1007/bf01658384

Cited by 9 publications

(5 citation statements)

References 14 publications

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“…Blood loss in the liver injury model with no treatment was 357.57 ± 267.31 µL and lasted the entire experimental period. These findings are similar to those in the literature when 2.5% to 4% of the liver was resected and bleeding lasted between 5–9 minutes with 1.0 to 3.4 mL of blood lost (Alwmark et al, 1986; Bengmark et al, 1980; Bengmark et al, 1981; Holcomb et al, 2000; Kullendorff et al, 1984; Lindfeldt et al, 1987; Tanaka et al, 1985; Zoucas et al, 1982; Zoucas et al, 1984a; Zoucas et al, 1984b;). Additionally, Holcomb et al (2000) demonstrated a reduction in blood loss by 52% using fibrin glue in a model of median hepatic lobe injury in rats.…”

Section: Discussionsupporting

confidence: 89%

“…Evaluations of existing techniques for determining blood loss were imprecise and highly variable. Historically, blood loss determinations in models of liver, spleen or kidney wound were performed using a preweighed aluminum cup (Bengmark et al, 1980; Kullendorff et al, 1984; Kullendorff and Zoucas, 1985; Lindblom et al, 1990; Lindfeldt et al, 1987; Vagianos et al, 1987; Zoucas et al, 1984a; Zoucas et al, 1984b;) or a stack of gauze pads (Holcomb et al, 2000; Tuthill et al, 2001) and determining final blood loss by weight. A more extensive search of the literature provided a protocol for hematin determination (Masci et al, 1988) and coupled with the use of Whatman filter paper “chads” this provided the desired accuracy.…”

Section: Discussionmentioning

confidence: 99%

“…Resection varied from approximately 2.5–65% of the liver (Alwmark et al, 1986; Bengmark et al, 1980; Kullendorff et al, 1984; Kullendorff and Zoucas, 1985; Lindfeldt et al, 1987; Vagianos et al, 1987; Zoucas et al, 1982), 6–10% of kidney (Jackson et al, 1998; Kullendorff and Zoucas, 1985, Raccuia et al, 1992) or 1% of the caudal pole of the spleen (Lindblom et al, 1990). Most papers stated that resection followed a standardized technique, although only one article employed the use of a template to resect a standardized 10% of the kidney, thereby producing an actively bleeding area of 1×5 cm (Raccuia et al, 1992).…”

Section: Discussionmentioning

confidence: 99%

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Hemostatic properties of a venomic protein in rat organ trauma

Warner¹,

McClintock²,

Barron³

et al. 2009

Experimental and Molecular Pathology

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Previous in vitro work characterized the protease Q8009 isolated from the venom of the Australian brown snake Pseudonaja textilis textilis with Factor Xa-like activity and hemostatic properties. The purpose of the work described here characterizes the in vivo hemostatic properties in a rat model of parenchymatous organ injury. The key parameters of activity included reduction in time-tohemostasis and total volume of blood loss in spleen, liver and kidney wound models in rats. The surgical protocols involved exposure of the organs via a midline abdominal laparotomy. Using a clean metal template with 6, 6.5 9 mm holes for spleen, liver and kidney, respectively, a predetermined volume of the organ was gently extruded through the template hole and excised with a razor blade. About 50 to 75 µL of collagen matrix with the different test solutions was applied to the wounds. Blood was collected and at the end of the procedure animals were humanely sacrificed with an anesthetic overdose. Determination of blood was performed using the hematin assay using a standard curve. Blood loss per minute and total blood loss were calculated. Results from the studies demonstrated that the application of Q8009 and collagen matrix to surgical wounds significantly reduced the total amount of blood loss and the time-to-hemostasis. In the spleen wound model, Q8009 at 100, 250 and 1000 µg/ml) significantly reduced (p<0.001) the total volume of blood lost relative to thrombin and reduced the time-to-hemostasis by 25-50%, as compared to 7% by thrombin. In the liver wound model, Q8009 at 250 and 1000 µg/ml significantly reduced (p<0.001) the total volume of blood lost relative to thrombin and reduced the time-to-hemostasis from 10.5 minutes by thrombin to 5.6 minutes with Q8009. In the kidney wound model, Q8009 at 250 µg/ml significantly reduced (p<0.05) the total volume of blood lost and reduced the time-to-hemostasis by 25% when compared to thrombin. The hemostasis levels were consistent with previous findings in skin wound rat models where Q8009 consistently reduced the total volume of blood lost and shortened time-to-hemostasis. Application of Q8009 plus collagen matrix significantly reduced the volume of total blood loss and time-to-hemostasis in rat surgical organ wound models induced bleeding, as compared to a commercially available hemostat device. The protein Q8009 has greater capacity to reduce blood

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Hemostatic properties of a venomic protein in rat organ trauma

Warner¹,

McClintock²,

Barron³

et al. 2009

Experimental and Molecular Pathology

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“…Experimental studies of denervation in a rat model have shown excessive bleeding at resection in the denervated liver (18). This is postulated to occur secondary to failure of the normal vasoconstrictor response.…”

Section: Discussionmentioning

confidence: 99%

Increased galactose clearance after liver transplantation: A measure of increased blood flow through the denervated liver?

et al. 1989

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This study measured the liver blood flow-dependent index of galactose clearance in patients after liver transplantation, to test the hypothesis that liver blood flow is increased in the denervated liver. Eight normal subjects and 16 patients 1 to 8 months after liver transplant were studied. All patients were stable with no evidence of severe rejection at the time of study. Galactose clearance was measured at steady state during continuous infusion of 75 mg per min of 5% galactose. The results show a statistically significant (p less than 0.01) higher average galactose clearance in the transplant patients (1,187 +/- 316 ml per min per m2) compared to the control group (709 +/- 121 ml per min per m2). The major limiting factor in galactose clearance at low concentrations is liver blood flow, and we interpret these data as evidence for increased blood flow in the transplanted liver. Possible mechanisms for the increased galactose clearance are (i) loss of normal vasomotor tone in the denervated liver, or (ii) persistence of abnormal systemic hemodynamics after transplantation. Elucidation of these mechanisms awaits further study.

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“…In both cases, alterations in blood flow to the liver may be involved. Although there is no experimen¬ tal evidence of changes in blood flow after liver denervation, it has been demonstrated that there is a 3to 4-fold increase in blood loss after standard¬ ized liver resection in the rat if the resection is pre¬ ceded by denervation at the liver hilus (23).…”

Section: Discussionmentioning

confidence: 99%

Hepatic lipase activity after liver denervation in hypothyroid rats

Berg

Hammarström²,

Hansson³

et al. 1990

Acta Endocrinologica

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Hepatic hilar denervation, hepatic vagotomy or sham operation were performed in hypothyroid rats. Activities of hepatic lipase were measured nine days after surgery. Sham operation in itself was associated with a decrease of hepatic lipase activity by about 40% compared with non-operated animals. Both hilar denervation and hepatic vagotomy were associated with increased hepatic lipase activity (40% and 35%, compared with sham-operated animals). Liver contents of norepinephrine were reduced by about 90% after hilar denervation, whereas hepatic vagotomy did not affect norepinephrine levels. No major changes in lipids and lipoproteins were noted.

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Excessive bleeding at hepatic resection after experimental liver denervation

Cited by 9 publications

References 14 publications

Hemostatic properties of a venomic protein in rat organ trauma

Hemostatic properties of a venomic protein in rat organ trauma

Increased galactose clearance after liver transplantation: A measure of increased blood flow through the denervated liver?

Hepatic lipase activity after liver denervation in hypothyroid rats

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