Present Experiences with Hepatic Dearterialization in Liver Neoplasm

Bengmark, S; Fredlund, P; Hafström, Larsolof; Vang, J

doi:10.1159/000395682

Cited by 49 publications

(20 citation statements)

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“…In a recent study hepatic tissue oxy gen tension was immediately reduced follow ing clamping of the proper hepatic artery but was unaffected when portal blood flow was reduced [30], Even if arterial collaterals are seldom found primarily in rats [29] they develop rap idly after interruption of the arterial supply [6], This might be one reason why hepatic protein synthesis returned to normal 3 days after HAL. Also in man early development of collaterals was reported following HAL and might be one reason why HAL alone has not been successful in the treatment of liver tu mors [2,3], The importance of portal blood for the maintenance of normal liver function is well established. Hormones released by splanch nic organs into the portal venous system and substrates from the gastrointestinal tract in fluence morphology, regenerative capacity and function of the liver.…”

Section: Discussionmentioning

confidence: 99%

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Changes of Protein Synthesis in Liver Tissue following Ligation of Hepatic Artery or Portal Vein in Rats

J¹,

Seeman²,

Hasselgren³

1985

Eur Surg Res

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The effects of short-term (1 h) complete liver ischemia, hepatic artery ligation (HAL) and portal vein ligation (PVL) on protein synthesis and ATP in liver tissue were studied in rats. Protein synthesis was measured by determining rate of amino acid incorporation into protein in incubated liver slices and was reduced to 34% of the control value after 1 h of complete liver ischemia. ATP was reduced from 3.2 to 0.28 µmol × g-¹ wet weight. Following HAL for 1 h, protein synthesis was reduced to 63% of control value and ATP to 2.4 µmol × g-¹ wet weight. No significant changes of protein synthesis or ATP were noticed 1 h after PVL. The results indicate that deprivation of hepatic arterial blood plays a greater role than exclusion of portal blood for impairment of protein synthesis in short-lasting liver ischemia. The effect of complete ischemia was more pronounced than the sum effect of HAL and PVL, suggesting that accumulation of metabolites and tissue acidosis might contribute to the consequences of abolished blood supply in liver ischemia. In another series of experiments the effects of HAL and PVL on protein synthesis and ATP in liver tissue were studied after 1, 3 and 7 days. Protein synthesis was reduced 1 day after HAL but normalized after 3 days, probably reflecting development of collaterals. Following PVL, protein synthesis was reduced after 1 day and remained depressed up to 7 days at which time it was 55% of the control value. ATP in liver tissue was not significantly different from the control value 1 day after HAL of PVL but was slightly reduced 7 days after PVL. Thus, the results demonstrated that hepatic protein synthesis was rapidly reduced after HAL but returned to normal after a few days. The effects of PVL developed more slowly but were more pronounced and protracted. The effects of HAL are probably caused by hypoxia while reduced protein synthesis following PVL might reflect decreased inflow to the liver of other factors of importance for protein synthesis than oxygen, e.g., amino acids and hormones.

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Section: Discussionmentioning

confidence: 99%

“…Hepatic artery ligation (HAL) has been advo cated in the treatment of certain liver tumors, vascular lesions or trauma to the liver [2,21]. Ligation of portal vein branches was recom mended in the treatment of poorly vascular ized liver tumors [14], Portal blood flow to the liver is also reduced after portacaval shunting.…”

Section: Introductionmentioning

confidence: 99%

Changes of Protein Synthesis in Liver Tissue following Ligation of Hepatic Artery or Portal Vein in Rats

J¹,

Seeman²,

Hasselgren³

1985

Eur Surg Res

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“…hepatic carcinoma, hepatic artery aneurysm, arterio venous fistula, accidental hepatic artery injury and bleeding from lacerations after trauma to the liver (4,20,25,29). Investigations on the metabolic effects of hepatic artery ligation (HAL) have mainly shown changes of liver enzymes, potassium and coagulation factors in peripheral and hepatic venous blood (2 ,3 , 12, 14).…”

Section: Introductionmentioning

confidence: 99%

Amino Acid Incorporation into Liver Proteins during Short-Term Ligation of the Hepatic Artery in the Dog

Hasselgren¹,

Almersjö²,

Gustavsson³

et al. 1979

Eur Surg Res

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Amino acid incorporation into liver proteins was studied with an in vitro method during and after a short-term hepatic artery ligation (HAL) in the dog. The incorporation of amino acids into liver proteins was linear for up to 4 h of incubation. An optimal incorporation rate was found with the leucine concentration used in the medium. After 1 h of HAL, the incorporation rate was 58% (p < 0.01) of the initial value. After reopening the hepatic artery, the incorporation rate significantly increased and was 75% of the initial value 120 min after the HAL period. No changes in the concentration of potassium or liver enzymes in peripheral, portal or hepatic venous blood were seen during the experiments. It is concluded that the method used to study the incorporation of amino acids into liver proteins is a sensitive tool in evaluating the metabolic effects of a short-term HAL.

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“…Indeed, certain drugs are more efficient on anoxic cells (Roche, 1989) and reduced vascularisation can increase intratumoral drug concentration and dwelling time in cancer cells (Bengmark et al, 1974;Delaunoit et al, 2004).…”

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confidence: 99%

Arterial phase enhancement and body mass index are predictors of response to chemoembolisation for liver metastases of endocrine tumours

et al. 2006

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Transcatheter arterial chemoembolisation (TACE) has been reported to be an efficient treatment of liver metastases of endocrine tumours in short series of patients. However, several factors seem to affect its results. The aim of this work is to identify predictors of response to TACE for liver metastases of endocrine tumours. A total of 163 TACE procedures were performed in 67 patients between 1994 and 2004. Forty-four patients were treated with streptozotocin and 23 with doxorubicin. Primary tumour was located in the pancreas for 19 patients, and had been removed in 43. Thirty-eight tumours were functioning. Response rate was 37% (confidence interval [CI] 95%: 28 -49%). Median time to progression (TTP) was 14.5 months (CI 95%: 9 -41). In multivariate analysis (n ¼ 43), predictors of tumour response were body mass index (BMI) (odds ratio [OR]: 1.3; CI 95%: 1.04 -1.63; P ¼ 0.022), functioning type of tumour (OR: 7.31; CI 95%: 1.26 -42.5; P ¼ 0.027), arterial phase enhancement on abdominal computed tomography (CT) (OR: 8.11; CI 95%:1.06 -62; P ¼ 0.044) and use of streptozotocin for cytotoxic agent (OR: 21.3; CI 95%: 1.48 -306; P ¼ 0.025). Analysis of TTP predictors showed that BMI (hazard ratio [HR]: 0.85; CI 95%: 0.76 -0.86; P ¼ 0.01) and arterial phase enhancement (HR: 0.3; CI 95%: 0.12 -0.73; P ¼ 0.008) were associated with delayed progression. This large study confirms the previously reported results of TACE regarding its efficacy for the treatment of liver metastases of endocrine tumours. Arterial phase enhancement on abdominal CT and BMI are predictors of treatment's efficacy. Streptozotocin should be the preferred cytotoxic agent in order to save anthracycline for systemic chemotherapy.

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Present Experiences with Hepatic Dearterialization in Liver Neoplasm

Cited by 49 publications

References 0 publications

Changes of Protein Synthesis in Liver Tissue following Ligation of Hepatic Artery or Portal Vein in Rats

Changes of Protein Synthesis in Liver Tissue following Ligation of Hepatic Artery or Portal Vein in Rats

Amino Acid Incorporation into Liver Proteins during Short-Term Ligation of the Hepatic Artery in the Dog

Arterial phase enhancement and body mass index are predictors of response to chemoembolisation for liver metastases of endocrine tumours

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