Preserving Hepatic Artery Flow During Portal Triad Blood Inflow Occlusion Reduces Liver Ischemia-Reperfusion Injury in Rats

Chen, Yong Wei; Li, Chong Hui; Zhang, Ai Qun; Yang, Shi Zhong; Zhang, Wen Zhi; Dong, Jia Hong

doi:10.1016/j.jss.2010.11.913

Cited by 13 publications

(8 citation statements)

References 20 publications

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“…The results demonstrated that preserving HAF may significantly reduce the inflammatory response compared with the OPT method, which is generally produced by I/R-activated inflammatory cells (27). In a previous study, it was demonstrated that liver tissue malondialdehyde values were significantly lower and Na + -K + -ATPase activity was significantly higher in the OPV group compared with the OPT group (14). An imbalance between the expression of genes that are involved in vasoconstriction and vasodilation was also observed in the OPT group, but not in the OPV group (28).…”

Section: Discussionmentioning

confidence: 96%

“…However, none of these methods has been accepted as an ideal technique that results in reductions in liver injury and blood loss. It has previously been reported that OPV and preservation of HAF can significantly reduce hepatic I/R injury without increasing the risk of blood loss (14). This new surgical procedure provides better liver cytoprotection compared with OPT.…”

Section: Discussionmentioning

confidence: 99%

“…Following portal occlusion, LBF decreased significantly in both OPT and OPV groups. In a previous study it was demonstrated that the preservation of the hepatic artery when performing OPV may reduce I/R injury by supplying more oxygen to the liver and without markedly increasing blood loss compared with the Pringle maneuver in normal rats (14). …”

Section: Discussionmentioning

confidence: 99%

“…The procedure combined biliary recanalization and partial liver ischemia under portal blood bypass through the caudate lobe (14) and a partial hepatectomy was performed in all rats. Rats with OJ were anesthetized as described above.…”

Section: Methodsmentioning

confidence: 99%

“…At present, numerous occlusion strategies, including selective hemihepatic vascular occlusion, step-by-step vascular control and ischemic preconditioning have been designed to control the liver portal blood and reduce I/R injury (11–13). A method for occlusion of the portal vein (OPV), while preserving hepatic artery blood flow during liver surgery was initially proposed and was demonstrated to be effective in a rat model of normothermic liver I/R (14). Although partial hepatectomy is a good model for liver regeneration, the liver injury induced by predisposed OJ and operation-related I/R may lead to suppressed liver regeneration (7–9).…”

Section: Introductionmentioning

confidence: 99%

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Preserving hepatic artery flow during portal triad blood occlusion improves regeneration of the remnant liver in rats with obstructive jaundice following partial hepatectomy

Kong

et al. 2018

Exp Ther Med

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In certain cases, major hepatectomy is essential and inevitable in patients with hilar cholangiocarcinoma and obstructive jaundice (OJ). The current study was designed to evaluate effects of a novel method of portal blood occlusion, where the portal vein was occluded (OPV) and the hepatic artery flow was preserved in rats with OJ that underwent partial hepatectomy. OJ was induced in rats by ligation of the common bile duct for 7 days. Subsequently, OJ rats underwent hepatectomy removing 76% of the liver following occlusion of the portal triad (OPT), OPV or without portal blood occlusion. Liver blood flow (LBF), liver damage and regeneration were assessed. The safety limit for the duration of liver ischemia was 20 min for OPT and 40 min for OPV in rats with OJ. OPT and OPV methods resulted in significantly decreased microvascular LBF in rats with OJ from 529.53±91.55 laser speckle perfusion units (LSPU) in the control to 136.89±32.32 and 183.99±49.25 LSPU, respectively. Liver damage was assessed analyzing levels of serum alanine transaminase and direct bilirubin, determining interleukin-1β and tumor necrosis factor-α expression and histological examination. It was demonstrated that liver damage and caspase-3 and −9 expression in the liver were substantially reduced in the OPV group compared with the OPT group. In addition, the OPV method significantly improved liver regeneration in OJ rats, as indicated by increased rates of liver regeneration and expression of proliferating cell nuclear antigen and Ki-67 compared with the OPT group. Therefore, the OPV method may prolong the duration of portal blood occlusion, reduce liver injury and improve liver regeneration by preserving hepatic arterial flow during portal blood control in rats with OJ undergoing partial hepatectomy. The current study describes a novel technique, which may be applied in liver surgery in patients with complex jaundice.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%