Excessive portal flow causes graft failure in extremely small-fo-size liver transplantation in pigs

Hong Sheng Wang, Nobuhiro Ohkohchi, Yoshitaka Enomoto, Masahiro Usuda, Shigehito Miyagi, Takeshi Asakura, Hiroo Masuoka, Takashi Aiso, Keisuke Fukushima, Tomohiro Narita, Hideyuki Yamaya, Atsushi Nakamura, Satoshi Sekiguchi, Naoki Kawagishi, Akira Sato, Susumu Satomi

Research output: Contribution to journalArticlepeer-review

34 Citations (Scopus)

Abstract

Aim: To evaluate the effects of a portocaval shunt on the decrease of excessive portal flow for the prevention of sinusoidal microcirculatory injury in extremely small-for-size liver transplantation in pigs. Methods: The right lateral lobe of pigs, i.e. the 25% of the liver, was transplanted orthotopically. The pigs were divided into two groups: graft without portocaval shunt (n = 11) and graft with portocaval shunt (n = 11). Survival rate, portal flow, hepatic arterial flow, and histological findings were investigated. Results: In the group without portocaval shunt, all pigs except one died of liver dysfunction within 24 h after transplantation. In the group with portocaval shunt, eight pigs survived for more than 4 d. The portal flow volumes before and after transplantation in the group without portocaval shunt were 118.2±26.9 mL/min/100 g liver tissue and 270.5±72.9 mL/min/100 g liver tissue, respectively. On the other hand, in the group with portocaval shunt, those volumes were 124.2±27.8 mL/min/100 g liver tissue and 42.7±32.3 mL/min /100 g liver tissue, respectively (P<0.01). As for histological findings in the group without portocaval shunt, destruction of the sinusoidal lining and bleeding in the peri-portal areas were observed after reperfusion, but these findings were not recognized in the group with portocaval shunt. Conclusion: These results suggest that excessive portal flow is attributed to post transplant liver dysfunction after extreme small-for-size liver transplantation caused by sinusoidal microcirculatory injury.

Original languageEnglish
Pages (from-to)6954-6959
Number of pages6
JournalWorld Journal of Gastroenterology
Volume11
Issue number44
DOIs
Publication statusPublished - 2005 Nov 28

Keywords

  • Hyperperfusion syndrome
  • Liver regeneration
  • Portocaval shunt
  • Postoperative liver dysfunction
  • Sinusoidal microcirculatory injury
  • Small-for-size liver transplantation

ASJC Scopus subject areas

  • Gastroenterology

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