Experimental study of the evaluation of liver function on the opposite side during portacaval anastomosis and ligation of the left portal branch

Abstract

: Background. Hepatocellular carcinoma is likely to accompany liver cirrhosis in which the portal pressure increases with portasystemic shunt. When portal tumor thrombus is present in the primary bifurcation, blood flow differs between the thrombolic lobe and the non-thrombolic lobe. In those cases, it is difficult to evaluate exactly residual liver function by conventional test. Therefore, the following studies were performed.Materials and Methods. Adult mongrel dogs are divided into a control group (C group), group undergoing ligation of the left portal branch (PL group), group undergoing portacaval anastomosis (PCS group) and group undergoing both ligation of the left portal branch and portacaval anastomosis (PL+PCSgroup)(n=5). ICG-R15 and MEGX15 in peripheral venous blood and right hepatic venous blood were determined. Mitchondrial metabolic capacity (adenosine triphosphate level, energy charge) was measured by high-performance liquid chromatography using liver biopsied specimens.Results

Indocyanine green R15 ratio depends directly on liver perfusion flow rate

“…These measures are also used to determine liver blood flow [31]. After major liver surgery such as liver resection and, especially, after liver transplantation, hyperdynamic circulatory states are frequently reported with alterations in splanchnic perfusion []. Therefore, monitoring liver function in the early states after transplantation or major liver resection with flow‐dependent tests such as ICG R15 is a complicated process [36, 37].…”

Peripheral Blood Stem Cell Transplantation Improves Liver Functional Reserve

“…ICG clearance rates depend primarily on the number of viable liver cells, blood flow rates, and functional biliary excretion. The retention rate of ICG at 15 minutes (ICG R15) is used as the measure of liver functional reserve [ 6 , 7 ]. In this study, we used autologous peripheral blood stem cell transplantation to treat patients with hepatitis B-induced decompensated cirrhosis.…”

Evaluation of serum lidocaine/monoethylglycylxylidide concentration to assess shunt closure in dogs with extrahepatic portosystemic shunts

“…24 Findings of this study suggest that MEGX reflects the function of mitochondria in the hepatic cells. 24 Lidocaine is a cheap and widely available analgesic drug that has a wide safety margin. 32 Lidocaine in plasma is partially unbound (pharmacologically active fraction) and partially bound to plasma proteins (reservoir fraction).…”

“…In an experimental study in dogs that underwent ligation of 1 of the portal branches, dogs in which a portocaval anastomosis was created and dogs in which both 1 of the portal branches was ligated and a portocaval anastomosis was created, the lidocaine/MEGX test was performed. 24 Findings of this study suggest that MEGX reflects the function of mitochondria in the hepatic cells 24 . In dogs with a congenital EHPSS, lidocaine clearance significantly increased after surgical attenuation in dogs with closed EHPSS, whereas no significant change in lidocaine concentrations over time could be detected in dogs with persistent shunting.…”