Flow- and pressure-adapted portal arterialization in dogs

Asakawa, Hiroichi; Kasai, S.; Mito, Michio

doi:10.1007/bf02469920

Cited by 14 publications

(10 citation statements)

References 11 publications

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“…No significant change was observed in the PA group after perfusion. In contrast, the ALT level in the PVA group increased after perfusion as previously reported in dogs and rats [1,9], with significantly higher values than those of the PA group throughout the experimental period.…”

Section: Experimental Designsupporting

confidence: 82%

Hepatic Oxygen Supply, Energy Charge, and Histological Findings in Dogs with Portal Vein Arterialization.

Yamazoe

Yanai

Matsuki

et al. 1997

The Journal of Veterinary Medical Science

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ABSTRACT. Hepatic oxygen supply, energy charge (EC), and histology were examined comparatively in dogs with portal vein anastomosis (PVA group), and PA in addition to PVA (PA group). The PVA group showed a lower level of hepatic oxygen supply than those of the PA group throughout the experimental period, and also showed decreases of adenosine triphosphate (ATP) and EC level after blood perfusion. In contrast, the oxygen supply and consumption were stable in the PA group. A temporary fall of ATP level was followed by recovery to the preperfusion level in the PA group. Histological examination indicated the collapse of hepatic cords with granular and vacuolar degeneration in only the PVA group. These findings suggested that PA, when supplemented to PVA, is an available technique for preventing hepatic failure caused by ischemic conditions. -KEY WORDS: canine, liver, portal arterialization.

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Section: Experimental Designsupporting

confidence: 82%

Hepatic Oxygen Supply, Energy Charge, and Histological Findings in Dogs with Portal Vein Arterialization.

Yamazoe

Yanai

Matsuki

et al. 1997

The Journal of Veterinary Medical Science

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“…As one of the long-term sequelae of PVA with no reduction of pressure, development of perivascular fibrosis and formation of thromboses in dilated portal vein branches have been reported (33,34). The purpose of reducing the flow in the arterialized portal vein is to avoid the development of hepatic fibrosis and reduce the shunt volume that leads to right-heart overload.…”

Section: Discussionmentioning

confidence: 98%

Effects of Portal Vein Arterialization on Regeneration and Morphology in Liver Transplantation: Investigations Using the Rat Model

Müller

Brummer²,

Kißler³

et al. 2004

Transplantation

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These operative techniques represent an excellent small animal model for studying the mechanism of liver regeneration and the genesis of fibrosis in liver and vessel tissue. The presenting findings indicate that the negative effects of "overarterialization" may be largely avoided by reducing portal blood flow. This implies that permanent PVA in clinical liver transplantation should be performed only in conjunction with a down-regulation of portal flow.

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“…Clinical experience and findings indicate that structural changes in the graft occur as a result of ''over-arterialisation'' of the graft. As one of the long-term sequelae of PVA with unrestricted inflow in the PV, the development of a fibrosis has been reported [8,36,37]. The purpose of reducing the portal inflow is to avoid the development of hepatic fibrosis [7].…”

Section: Discussionmentioning

confidence: 99%

Arterialisation of the portal vein as a model for the induction of hepatic fibrosis: description of microsurgical models in the rat

Müller

Brummer²,

Erhardt³

et al. 2005

Transpl Int

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Within the framework of liver transplantation, arterialisation of the portal vein in the case of non-recanalisable thrombosis has been reactivated. However, one of the consequences of this vascular reconstruction is the development of hepatic fibrosis. Clinical experience has shown that the development of fibrosis can be avoided by reducing portal inflow. We present, as a model for the induction of hepatic fibrosis, techniques of PVA, including transplantation. For PVA, several different techniques were used: the first with reduction of the portal inflow over a stent inserted in the right renal artery (PVA-B), the second with unrestricted flow using an aortic-portal segment (PVA-APS). The third technique was orthotopic liver transplantation with unrestricted portal arterialisation (OLTx-APS). Portal blood flow was measured with an ultrasonic flow probe. To determine the degree of hepatic fibrosis the amount of hydroxyproline was measured. Quantification of relative transcript levels of procollagen I was effected with real-time PCR using the TaqMan technology on a lightcycler instrument. The extracellular matrix was visualised with picro-sirius staining. Measurements with the ultrasonic probe showed a significant increase in flow rates, both with reduced (PVA-B) and unrestricted inflow (PVA-APS; OLTx-APS). The lowest survival rate (58%) was found in the group with unrestricted portal inflow. The reason for this was a high rate of thrombosis in the in the portal vascular tree (4 out of 12). In the OLTx-APS group four animals died within the first 3 postoperative days (69%), as a result of protracted postoperative shock. The overall survival rate was the highest (85%) in the group undergoing PVA with reduction of the portal inflow. PVA with unrestricted inflow was followed by a significant increase in extracellular collagen, which showed a clear correlation with the increase in the amount of hydroxyproline, the level of the mRNA for procollagen I and picro-sirius staining. With the operative PVA techniques presented herein, different arterial flow rates in the portal vein can be investigated. In our opinion these techniques represent an excellent animal model for studying the genesis of fibrosis and antifibrotic substances. By regulating the blood flow in the arterialised portal vein hepatic fibrosis can be reduced or even avoided. After a brief period of learning the microsurgical techniques, the surgeon can limit clamping times and achieve good results with these techniques.

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Flow- and pressure-adapted portal arterialization in dogs

Cited by 14 publications

References 11 publications

Hepatic Oxygen Supply, Energy Charge, and Histological Findings in Dogs with Portal Vein Arterialization.

Hepatic Oxygen Supply, Energy Charge, and Histological Findings in Dogs with Portal Vein Arterialization.

Effects of Portal Vein Arterialization on Regeneration and Morphology in Liver Transplantation: Investigations Using the Rat Model

Arterialisation of the portal vein as a model for the induction of hepatic fibrosis: description of microsurgical models in the rat

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