TY - JOUR
T1 - Excessive portal flow causes graft failure in extremely small-fo-size liver transplantation in pigs
AU - Wang, Hong Sheng
AU - Ohkohchi, Nobuhiro
AU - Enomoto, Yoshitaka
AU - Usuda, Masahiro
AU - Miyagi, Shigehito
AU - Asakura, Takeshi
AU - Masuoka, Hiroo
AU - Aiso, Takashi
AU - Fukushima, Keisuke
AU - Narita, Tomohiro
AU - Yamaya, Hideyuki
AU - Nakamura, Atsushi
AU - Sekiguchi, Satoshi
AU - Kawagishi, Naoki
AU - Sato, Akira
AU - Satomi, Susumu
PY - 2005/11/28
Y1 - 2005/11/28
N2 - 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.
AB - 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.
KW - Hyperperfusion syndrome
KW - Liver regeneration
KW - Portocaval shunt
KW - Postoperative liver dysfunction
KW - Sinusoidal microcirculatory injury
KW - Small-for-size liver transplantation
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U2 - 10.3748/wjg.v11.i44.6954
DO - 10.3748/wjg.v11.i44.6954
M3 - Article
C2 - 16437599
AN - SCOPUS:31144441949
VL - 11
SP - 6954
EP - 6959
JO - World Journal of Gastroenterology
JF - World Journal of Gastroenterology
SN - 1007-9327
IS - 44
ER -