Norepinephrine in Small-For-Size Liver Grafts: An Experimental Study in Pigs

Kostopanagiotou, Georgia; Pandazi, Ageliki; Arkadopoulos, Nikolaos; Theodoraki, Kassiani; Mystakidou, Kyriaki; Costopanagiotou, Constantinos; Chondroudaki, Ioanna; Smyrniotis, Vassilios

doi:10.1016/j.jss.2006.11.005

Cited by 8 publications

(10 citation statements)

References 16 publications

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“…This study confirms the findings of other authors that catecholamine levels, in particular NE, are elevated immediately following transplantation of partial liver allograft [14,15] and are highest in the smallest grafts. NE levels in the 20% grafts peaked at 6 hours post reperfusion and remained elevated up to POD7.…”

Section: Discussionsupporting

confidence: 93%

“…Their effects on hepatic artery flow (HAF) in partial liver transplantation have been studied by several groups [14,15]. Hickman was the first to report elevated catecholamine levels in a partial liver graft using a non-survival porcine model [14] and Kostopanagiotou confirmed elevation of perioperative 1 To whom correspondence and reprint requests should be addressed at Department of Liver Transplantation and Hepato-biliary Surgery, A100, Cleveland Clinic, Cleveland, OH 44195.…”

Section: Introductionmentioning

confidence: 99%

“…NE levels using small grafts [15] and suggested that this was the cause of reduced HAF in the peri-operative period. HA vasospasm, secondary to increased sympathetic activity, has been implicated as a cause of graft dysfunction in a porcine asphyxia model by D'Alessandro, where HA vasospasm was prevented using an alpha adrenergic blocker [9].…”

Section: Introductionmentioning

confidence: 99%

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Elevated Catecholamines and Hepatic Artery Vasospasm in Porcine Small-for-Size Liver Graft

Zhu

Fung

Nakagawa

et al. 2012

Journal of Surgical Research

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Elevated Catecholamines and Hepatic Artery Vasospasm in Porcine Small-for-Size Liver Graft

Zhu

Fung

Nakagawa

et al. 2012

Journal of Surgical Research

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“…Pathophysiologically, this can be seen secondary to increased edema, vasospasm of the hepatic arterioles, or PHP . This arterial vasoconstriction can have serious consequences, including posttransplant biliary strictures and ischemia/reperfusion injury, and may play a role in small‐for‐size syndrome (SFSS) . Clinically, persistently elevated postoperative PHP can manifest as refractory ascites and hepatic hydrothorax .…”

Section: Discussionmentioning

confidence: 99%

“…14 This arterial vasoconstriction can have serious consequences, including posttransplant biliary strictures 7 and ischemia/reperfusion injury, 8 and may play a role in small-for-size syndrome (SFSS). 6,14 Clinically, persistently elevated postoperative PHP can manifest as refractory ascites and hepatic hydrothorax. 15,16 Unfortunately, no data exist on the incidence of HAT in the setting of PHP.…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of splenic artery embolization for portal hyperperfusion in liver transplant recipients: A 5‐year experience

Presser¹,

Quintini

Tom

et al. 2015

Liver Transpl

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Severe portal hyperperfusion (PHP) after liver transplantation has been shown to cause intrahepatic arterial vasoconstriction secondary to increased adenosine washout (hepatic artery buffer response). Clinically, posttransplant PHP can cause severe cases of refractory ascites and hydrothorax. In the past, we reported our preliminary experience with the use of splenic artery embolization (SAE) as a way to reduce PHP. Here we present our 5-year experience with SAE in orthotopic liver transplantation (OLT). Between January 2007 and December 2011, 681 patients underwent OLT at our institution, and 54 of these patients underwent SAE for increased hepatic arterial resistance and PHP (n 5 42) or refractory ascites/hepatic hydrothorax (n 5 12). Patients undergoing SAE were compared to a control group matched by year of embolization, calculated Model for End-Stage Liver Disease score, and liver weight. SAE resulted in improvements in hepatic artery resistive indices (0.92 6 0.14 and 0.76 6 0.10 before and after SAE, respectively; P < 0.001) and improved hepatic arterial blood flow (HAF; 15.6 6 9.69 and 28.7 6 14.83, respectively; P < 0.001). Calculated splenic volumes and spleen/liver volume ratios were correlated with patients requiring SAE versus matched controls (P 5 0.002 and P 5 0.001, respectively). Among the 54 patients undergoing SAE, there was 1 case of postsplenectomy syndrome. No abscesses, significant infections, or bleeding was noted. We thus conclude that SAE is a safe and effective technique able to improve HAF parameters in patients with elevated portal venous flow and its sequelae. Liver Transpl 21:435-441, 2015. V C 2015 AASLD.

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Porcine models for the study of small‐for‐size syndrome and portal inflow modulation: literature review and proposal for a standardized nomenclature

Mohkam

Darnis

Mabrut

2016

J Hepato Biliary Pancreat

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Porcine models of extended hepatectomy and liver transplantation (LT) of reduced graft have been widely used for studying the small-for-size (SFS) syndrome and the various modalities of portal inflow modulation (PIM). However, considerable heterogeneity exists among the studies and their results. The aim of this review was to assess the main advantages and drawbacks of the different porcine models of SFS LT and SFS hepatectomy, and propose a standardized anatomical nomenclature for the various models. The MEDLINE database was searched for articles reporting porcine models of reduced graft LT or hepatectomy of more than 65%. Nineteen articles on SFS LT matched our inclusion criteria, including 10 articles reporting a model of PIM. Twenty-seven articles reporting a model of posthepatectomy SFS were identified, of which 16 reported a model of PIM. Subtotal hepatectomy (i.e. resection of all segments except segment 1) without inflow occlusion, left trisectionectomy with inflow occlusion, and LT of a right lateral section including the caudate lobe in a larger recipient appeared to be the most suitable porcine models for studying the SFS syndrome. All three models were appropriate for assessing the surgical and pharmaceutical PIM modalities, except for those involving the splenic flow.

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Norepinephrine in Small-For-Size Liver Grafts: An Experimental Study in Pigs

Cited by 8 publications

References 16 publications

Elevated Catecholamines and Hepatic Artery Vasospasm in Porcine Small-for-Size Liver Graft

Elevated Catecholamines and Hepatic Artery Vasospasm in Porcine Small-for-Size Liver Graft

Safety and efficacy of splenic artery embolization for portal hyperperfusion in liver transplant recipients: A 5‐year experience

Porcine models for the study of small‐for‐size syndrome and portal inflow modulation: literature review and proposal for a standardized nomenclature

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