Splenectomy improves survival by increasing arterial blood supply in a rat model of reduced-size liver

Eipel, Christian; Abshagen, Kerstin; Ritter, Jessica; Cantré, Daniel; Menger, Michael D.; Vollmar, Brigitte

doi:10.1111/j.1432-2277.2010.01079.x

Cited by 48 publications

(42 citation statements)

References 41 publications

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“…In particular, the reduced portal venous hyperperfusion resulting from a splenectomy was shown to be a factor driving liver regeneration [11,12]. The splenectomy-induced increase in hepatic arterial blood flow with increased oxygen supply was also suggested to induce liver regeneration [13]. In addition, increased hepatic oxygen delivery and hepatic oxygen consumption were observed in a rat model of massive hepatectomy with splenectomy [4].…”

Section: Discussionmentioning

confidence: 97%

Role of the spleen in liver regeneration in relation to transforming growth factor-β1 and hepatocyte growth factor

Lee

Jeong

Choi

et al. 2015

Journal of Surgical Research

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Section: Discussionmentioning

confidence: 97%

Role of the spleen in liver regeneration in relation to transforming growth factor-β1 and hepatocyte growth factor

Lee

Jeong

Choi

et al. 2015

Journal of Surgical Research

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“…It appeared that after a 90% partial hepatectomy, the splenectomy improved postoperative liver function and survival in rat, by increasing the oxygen supply and decreasing the portal flow. 50,51 Embolization or ligation of the splenic artery has also been proposed as an option to modulate portal flow in case of small for size syndrome with portal hypertension. 52,53 CONCLUSIONS An intraoperative elevation of PVP after major hepatectomy is clearly correlated with outcome and incidence of PLF.…”

Section: Discussionmentioning

confidence: 99%

Posthepatectomy Portal Vein Pressure Predicts Liver Failure and Mortality after Major Liver Resection on Noncirrhotic Liver

et al. 2013

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“…In contrast, this mechanism may have little or no importance when there is compensatory blood flow between liver lobes through sinusoidal collaterals such as in PVL. Interestingly, reduced arterial flow has been demonstrated repeatedly in regenerating livers in animal models of partial hepatectomy, [24][25][26] smallfor-size live donor liver transplantation 25,27 and in models of liver regeneration after PVL, 10 but its role as the accelerator of liver regeneration has so far not been understood.…”

Section: Discussionmentioning

confidence: 99%

“…5,10 In stark contrast to our findings, hypoxia has been viewed by most as detrimental to liver regeneration, 28 and abrogating hypoxia through surgical maneuvers, like portal vein arterialization, has been considered beneficial to the regenerating liver. 25 Recently, investigators described the presence of the master regulator of hypoxia HIF-1a in regenerating livers after resection, 29,30 not just in response to hypoxic injury but as an important regulator of hepatic metabolism in general. 31,32 It also has been demonstrated that liver regeneration is actually increased in mice deficient for PHD-1 and that increased HIF-1a activity in the regenerating liver not only induced a protective response, but also accelerated liver regeneration.…”

Section: Article In Pressmentioning

confidence: 99%

Hypoxia of the growing liver accelerates regeneration

Schadde

Tsatsaris

Swiderska‐Syn

et al. 2017

Surgery

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Background. After portal vein ligation of 1 side of the liver, the other side regenerates at a slow rate. This slow growth may be accelerated to rapid growth by adding a transection between the 2 sides, i.e., performing portal vein ligation and parenchymal transection. We found that in patients undergoing portal vein ligation and parenchymal transection, portal vein hyperflow in the regenerating liver causes a significant reduction of arterial flow due to the hepatic arterial buffer response. We postulated that the reduction of arterial flow induces hypoxia in the regenerating liver and used a rat model to assess hypoxia and its impact on kinetic growth. Methods. A rat model of rapid (portal vein ligation and parenchymal transection) and slow regeneration (portal vein ligation) was established. Portal vein flow and pressure data were collected. Liver regeneration was assessed in rats using computed tomography, proliferation with Ki-67, and hypoxia with pimonidazole and HIF-1a staining. Results. The rat model confirmed acceleration of regeneration in portal vein ligation and parenchymal transection as well as the portal vein hyperflow seen in patients. Additionally, tissue hypoxia was observed after portal vein ligation and parenchymal transection, while little hypoxia staining was detected after portal vein ligation. To determine if hypoxia is a consequence or an inciting stimulus of rapid liver regeneration, we used a prolylhydroxylase blocker to activate hypoxia signaling pathways in the slow model. This clearly accelerated slow to rapid liver regeneration. Inversely, abrogation of hypoxia led to a blunting of rapid growth to slow growth. The topical application of prolyl-hydroxylase inhibitors on livers in rats induced spontaneous areas of regeneration. Conclusion. This study shows that pharmacologically induced hypoxic signaling accelerates liver regeneration similar to portal vein ligation and parenchymal transection. Hypoxia is likely an accelerator of liver regeneration. Also, prolyl-hydroxylase inhibitors may be used to enhance liver regeneration pharmaceutically. Background. After portal vein ligation of 1 side of the liver, the other side regenerates at a slow rate. This slow growth may be accelerated to rapid growth by adding a transection between the 2 sides, i.e., performing portal vein ligation and parenchymal transection. We found that in patients undergoing portal vein ligation and parenchymal transection, portal vein hyperflow in the regenerating liver causes a significant reduction of arterial flow due to the hepatic arterial buffer response. We postulated that the reduction of arterial flow induces hypoxia in the regenerating liver and used a rat model to assess hypoxia and its impact on kinetic growth. Methods. A rat model of rapid (portal vein ligation and parenchymal transection) and slow regeneration (portal vein ligation) was established. Portal vein flow and pressure data were collected. Liver regeneration was assessed in rats using computed tomography, proliferation with Ki-6...

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Splenectomy improves survival by increasing arterial blood supply in a rat model of reduced-size liver

Cited by 48 publications

References 41 publications

Role of the spleen in liver regeneration in relation to transforming growth factor-β1 and hepatocyte growth factor

Role of the spleen in liver regeneration in relation to transforming growth factor-β1 and hepatocyte growth factor

Posthepatectomy Portal Vein Pressure Predicts Liver Failure and Mortality after Major Liver Resection on Noncirrhotic Liver

Hypoxia of the growing liver accelerates regeneration

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