Portal vein arterialization for acute hepatic failure in rats

doi:10.3969/j.issn.2095-4344.0208

Abstract

Abstract:

BACKGROUND: Partial portal vein arterialization (PPVA) can slow the progression of liver failure by increasing the blood supply.
OBJECTIVE: To explore the effects of PPVA on the liver function and pathological changes in a rat model of liver failure.
METHODS: Totally 130 Sprague-Dawley rats were randomized into three groups: PPVA group (n=50) underwent left nephrectomy, the PPVA model was established by sleeve suturing and cuff technology, and then D-galactosamine was intraperitoneally administered at the dose of 1 300 mg/kg to induce acute liver failure; liver failure group (n=50) underwent left nephrectomy, the portal vein was dissociated, ligated for 16 minutes and then mobilized, and D-galactosamine was intraperitoneally administered at the dose of 1 300 mg/kg to induce acute liver failure after abdominal closure; control group (n=30) received left nephrectomy, the portal vein was ligated for 16 minutes and then mobilized, and same volume of normal saline was intraperitoneally administered after abdominal closure. The serological and pathological changes of the liver tissue were observed at 12, 24, 36, 48 and 72 postoperative hours.
RESULTS AND CONCLUSION: Animal models (n=30 per group) were made successfully, the survival rate was 70% and 53%, respectively, and there was a significant difference between two groups after modeling (P < 0.05). The survival rate in the control group was 100% at 72 postoperative hours. The serum levels of glutamic-oxalacetic transaminease, alanineaminotranferase, interleukin 6, tumor necrosis factor α, and endotoxin in the portal vein in the control group were significantly lower than those in the other two groups at different time points postoperatively (P < 0.05). In the PVA group, the serum levels of glutamic-oxalacetic transaminease and alanineaminotranferase at postoperative different time points postoperatively, the serum levels of total bilrubin, interleukin 6, tumor necrosis factor α, and endotoxin level in the portal vein at 24-72 postoperative hours, and albumin at 36-72 postoperative hours were significantly lower than those in the liver failure group (P < 0.05). At 72 postoperative hours, the liver structure was complete in the control group, hepatic lobules were damaged accompanied with abundant inflammatory cell infiltration in the liver failure group and the pathological lesions were improved in the PVA group. To conclude, PVA can improve liver function and slow the progression of liver failure to certain extents.

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

Key words: Liver Failure, Acute, Alanine Transaminase, Bilirubin

CLC Number:

R318

Chen Peng, Jiang Yi, Zhang Xiao-jin. Portal vein arterialization for acute hepatic failure in rats[J]. Chinese Journal of Tissue Engineering Research, 2018, 22(12): 1895-1901.

Figures/Tables 4

References

[1] 段钟平,陈煜.肝衰竭诊疗: 进展与展望[J].临床肝胆病杂志, 2012, 28(10):721-725.

[2] 中华医学会感染病学分会肝衰竭与人工肝学组,中华医学会肝病学分会重型肝病与人工肝学组．肝衰竭诊治指南[J].中华临床感染病杂志,2012,5(6):321-327．

[3] 叶一农,高志良.乙型肝炎肝衰竭发生机制中的三重打击[J].传染病信息,2009,22(5):276-279．

[4] 中华医学会肝病学分会重型肝病与人工肝学组,中华医学会感染病学分会肝衰竭与人工肝学组.肝衰竭诊疗指南[J].中华肝脏病杂志, 2006,14(9):643-646.

[5] Mabuchi A,Mullaney I,Sheard P,et al.Role of hepatic stellate cells in the early phase of liver regeneration in rat: formation of tight adhesion to parenchymal cells.Comp Hepatol.2004;3 Suppl 1:S29.

[6] Cohn R,Herrod C.Some effects upon the liver of complete arterialization of its blood supply. Surgery.1952;32(2):214.

[7] Fisher B,Russ C,Updegraff H.A suitable technique for total arterialization of the dog liver.Surgery.Surgery. 1954;35(6): 879-884.

[8] Schleimer K,Stippel DL,Kasper HU,et al.Improved microcirculation of a liver graft by controlled portal vein arterialization.J Surg Res.2004;116(2):202-210.

[9] Margarit C,Bilbao I,Charco R,et al.Auxiliary heterotopic liver transplantation with portal vein arterialization for fulminant hepatic failure.Liver Transpl.2000;6(6):805-809.

[10] 刘琦,李坚,关晓东,等.入肝门静脉动脉化加门腔分流术对肝硬化大鼠血流动力学的影响[J].中华普通外科学文献(电子版),2010,4(2):16-19.

[11] Schleimer K,Stippel DL,Kasper HU,et al.Auxiliary liver transplantation with flow‐regulated portal vein arterialization offers a successful therapeutic option in acute hepatic failure–investigations in heterotopic auxiliary rat liver transplantation. Transplant Int.2006;19(7): 581-588.

[12] 陈永亮,黄晓强,黄志强,等.部分门静脉动脉化对大鼠肝脏血管铸型变化的影[J].中国普通外科杂志,2007,16(3):223-226.

[13] Fernández OM,Ríos A,Sánchez A,et al.Pathology findings in a model of auxiliary liver transplantation with portal vein arterialization in pigs.Transplant Proc.2005;37(9):3939-3942.

[14] Nardo B,Montalti R,Puviani L,et al.Portal vein oxygen supply through a liver extracorporeal device to treat acute liver failure in Swine induced by subtotal hepatectomy: preliminary data. Transplant Proc.2006;38(4):1190-1192.

[15] Nardo B,Tsivian M,Neri F,et al.Extracorporeal portal vein oxygenation improves outcome of acute liver failure in swine. Transplant Proc.2008;40(6):2046-2048.

[16] Tsivian M,Neri F,Prezzi D,et al.Portal vein arterialization in hepatobiliary surgery and liver transplantation.Transplantation proceedings.Elsevier.2007;39(6):1877-1878.

[17] Schleimer K,Stippel DL,Kasper HU,et al.Portal vein arterialization increases hepatocellular apoptosis and inhibits liver regeneration. J Surg Res.2008;149(2):250-258.

[18] Muller V,Ott R,Tannapfel A,et al.Arterialization of the portal vein in liver transplantation: a new microsurgical model in the rat. Transplantation.2001;71(7):977-981.

[19] Schleimer K,Stippel DL,Kasper HU,et al.Portal hyperperfusion causes disturbance of microcirculation and increased rate of hepatocellular apoptosis: investigations in heterotopic rat liver transplantation with portal vein arterialization.Transplant Proc. 2006;38(3):725-729.

[20] Seifter S,England S.Energy metabolism. In: Arias IM,et al (eds).The liver: biology and pathobiology, 3rd edn.Raven Press, New York,1994:323-364.

[21] Bonnet S,Sauvanet A,Bruno O,et al.Long-term survival after portal vein arterialization for portal vein thrombosis in orthotopic liver transplantation.Gastroenterol Clin Biol.2010;34(1):23-28.

[22] Pastor CM.Hepatic and splanchnic oxygen consumption during acute hypoxemic hypoxia in anesthetized pigs.Crit Care Med. 2000;28(3):765-773.

[23] Stieber AC,Zetti G,Todo S,et al.The spectrum of portal vein thrombosis in liver transplantation.Ann Surg.1991;213(3):199.

[24] Fan YD,Praet M,Van Huysse J,et al.Effects of portal vein arterialization on liver regeneration after partial hepatectomy in the rat.Liver Transpl.2002;8(2):146-152.

[25] Kruel CRP,de Fraga RS,Dal Molin S,et al.Hepatic reperfusion in rats: a new model with portal arterialization in studying early ischemia-reperfusion injury.Transplant Proc. 2007;39(10): 3015-3018.

[26] Schleimer K,Stippel DL,Kasper HU,et al.Improved microcirculation of a liver graft by controlled portal vein arterialization.J Surg Res.2004;116(2):202-210.

[27] 陈永亮,黄志强,王迎宾,等.门静脉动脉化对实验性梗阻性黄疸大鼠肝细胞凋亡的影响[J].中华普通外科杂志,2000,15(6):348-351.

[28] 吴均政,江艺,张小进,等.一种新的大鼠门静脉动脉化模型[J].中国组织工程研究,2011,15(15):2716-2720.

[29] 李兰娟,肖党生,吴仲文,等.急性肝衰竭大鼠肠道菌群和内毒素的动态研究[J].中华肝脏病杂志,2004,12(3):167-169.

[30] Takenaka K,Kanematsu T,Fukuzawa K,et al.Can hepatic failure after surgery for hepatocellular carcinoma in cirrhotic patients be prevented? World J Surg.1990;14(1):123-127.

[31] Pugh RNH,Murray-Lyon IM,Dawson JL,et al.Transection of the oesophagus for bleeding oesophageal varices.Br J Surg.1973; 60(8):646-649.

[32] Van Deventer SJ,Ten Cate JW,Tytgat GN.Intestinal endotoxemia. Clinical significanc. Gastroenterology.1988;94(3):825.

[33] 李兰娟,肖党生,吴仲文,等.急性肝衰竭大鼠肠道菌群和内毒素的动态研究[J].中华肝脏病杂志,2004, 12(3):167-169.

[34] Steuerwald NM,Foureau DM,Norton HJ,et al.Profiles of serum cytokines in acute drug-induced liver injury and their prognostic significance.PloS One.2013;8(12):e81974.

[35] Chastre A,Bélanger M,Beauchesne E,et al.Inflammatory cascades driven by tumor necrosis factor-alpha play a major role in the progression of acute liver failure and its neurological complications.PloS One.2012;7(11):e49670.

[36] Schwabe RF,Brenner DA.Mechanisms of liver injury. I. TNF-α-induced liver injury: role of IKK, JNK, and ROS pathways.Am J Physiol Gastrointest Liver Physiol.2006;290(4):G583-589.

[37] Lai HS,Lin WH,Lai SL,et al.Interleukin-6 mediates angiotensinogen gene expression during liver regeneration.PloS One.2013;8(7):e67868.

[38] Han Y,Runge MS,Brasier AR.Angiotensin II induces interleukin-6 transcription in vascular smooth muscle cells through pleiotropic activation of nuclear factor-κB transcription factors.Circ Res. 1999;84(6):695-703.