Takeyama O, Ikai I, Yagi T, Satoh S, Kanazawa A, Uesugi T, Nishitai R, Okabe H, Katsura N, Terajima H, Yamaoka Y
Department of Gastroenterological Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Liver Transpl. 2001 Jun;7(6):526-32. doi: 10.1053/jlts.2001.24906.
Xenogeneic extracorporeal liver perfusion (ECLP) has the potential to become an important tool in the management of patients with severe liver failure. We previously showed that xenogeneic pig liver perfusion may be prolonged for up to 9 hours by the administration of prostaglandin E(1) (PGE(1)). In this study, we used a canine model of acute liver failure to evaluate the effects of PGE(1) on the efficacy of ECLP as a liver-assist device. Liver failure was surgically induced in 12 beagle dogs, with a control group (group 1, n = 4) not connected to the ECLP circuit. Direct cross-circulation between the dogs and the ECLP circuit using a pig liver was performed without (group 2, n = 4) or with (group 3, n = 4) continuous administration of PGE(1) through the portal vein of the pig liver. The duration of cross-circulation in group 3 (9.4 +/- 1.2 hours) was significantly longer than in group 2 (4.3 +/- 1.0 hours). In addition, elevation of blood ammonia, total bile acid, and hyaluronic acid levels was less marked in group 3 compared with the other 2 groups. The ratio of branched-chain amino acids to aromatic amino acids was also improved in group 3. The mean survival time in group 3 (26.6 +/- 0.4 hours) was significantly longer than in group 1 (15.5 +/- 1.3 hours) or group 2 (17.1 +/- 2.9 hours). Continuous administration of PGE(1) to xenogeneic ECLP resulted in a significant improvement in both liver function and survival time of dogs with surgically induced liver failure.
异种体外肝灌注（ECLP）有可能成为治疗严重肝衰竭患者的一项重要工具。我们之前表明，通过给予前列腺素E(1)（PGE(1)），异种猪肝灌注可延长至9小时。在本研究中，我们使用急性肝衰竭犬模型来评估PGE(1)对作为肝辅助装置的ECLP疗效的影响。对12只比格犬进行手术诱导肝衰竭，其中一个对照组（第1组，n = 4）不连接到ECLP回路。使用猪肝在犬与ECLP回路之间进行直接交叉循环，其中一组（第2组，n = 4）不通过猪肝门静脉持续给予PGE(1)，另一组（第3组，n = 4）则持续给予PGE(1)。第3组的交叉循环持续时间（9.4±1.2小时）明显长于第2组（4.3±1.0小时）。此外，与其他两组相比，第3组血氨、总胆汁酸和透明质酸水平的升高不太明显。第3组支链氨基酸与芳香族氨基酸的比例也有所改善。第3组的平均生存时间（26.6±0.4小时）明显长于第1组（15.5±1.3小时）或第2组（17.1±2.9小时）。对异种ECLP持续给予PGE(1)可显著改善手术诱导肝衰竭犬的肝功能和生存时间。
