Farantos C, Arkadopoulos N, Theodoraki K, Kostopanagiotou G, Katis K, Tzavara K, Andreadou I, Dimopoulou K, Hatzoudi E, Sidiropoulou T, Skalkidis I, Paphiti A, Smyrniotis V
Second Department of Surgery, Athens University School of Medicine, Aretaieion University Hospital, Athens, Greece.
Eur Surg Res. 2008;40(4):347-53. doi: 10.1159/000118031. Epub 2008 Feb 26.
Portal flow diversion by portacaval shunts (PCS) has been shown to prevent primary graft nonfunction in liver transplantation using small-for-size grafts. In this study, we examine whether PCS can improve reperfusion injury after major hepatectomy in pigs.
In 14 pigs, a partial PCS was constructed following 65% hepatectomy and 1 h of inflow ischemia. During 24 h of reperfusion, the shunt was either closed (group A, n = 7) or left open (group B, n = 7).
24 h after reperfusion, group A had higher levels of alanine aminotransferase (70 +/- 12 IU/l vs. 51 +/- 5.9 IU/l; p < 0.05), alanine aminotransferase per gram of liver remnant (0.41 +/- 0.07 IU/l/g vs. 0.21 +/- 0.05 IU/l/g; p < 0.05), prothrombin time (24.1 +/- 2.4 s vs. 14.3 +/- 2.9 s; p < 0.05), international normalized ratio (2.11 +/- 0.15 vs. 1.29 +/- 0.28; p < 0.05), hepatocyte necrosis scores and percentages of nuclei stained for proliferating cell nuclear antigen (52.57 +/- 8.9% vs. 36.71 +/- 6%; p < 0.05) compared to group B.
Partial portal flow diversion appears to attenuate reperfusion injury in a porcine model of major hepatectomy.
门腔分流术（PCS）进行门静脉血流改道已被证明可预防小体积供肝肝移植中的原发性移植物无功能。在本研究中，我们探讨PCS是否能改善猪大肝切除术后的再灌注损伤。
对14头猪在进行65%肝切除和1小时入肝血流缺血后构建部分PCS。在24小时再灌注期间，分流要么关闭（A组，n = 7），要么保持开放（B组，n = 7）。
再灌注24小时后，与B组相比，A组丙氨酸转氨酶水平更高（70±12 IU/L对51±5.9 IU/L；p < 0.05），每克肝残余组织的丙氨酸转氨酶水平更高（0.41±0.07 IU/L/g对0.21±0.05 IU/L/g；p < 0.05），凝血酶原时间更长（24.1±2.4秒对14.3±2.9秒；p < 0.05），国际标准化比值更高（2.11±0.15对1.29±0.28；p < 0.05），肝细胞坏死评分以及增殖细胞核抗原染色阳性的细胞核百分比更高（52.57±8.9%对36.71±6%；p < 0.05）。
在猪大肝切除模型中，部分门静脉血流改道似乎可减轻再灌注损伤。
