Leng Jian-jun, Dong Jia-hong, Han Ben-li, Zheng Shu-guo, Wang Huai-zhi
Institute of Hepatobiliary Surgery, General Hospital of Chinese People's Liberation Army, Beijing 100853, China.
Zhonghua Wai Ke Za Zhi. 2009 Jul 15;47(14):1083-7.
To evaluate the protective effects of affiliating portasystemic shunt on small-for-size graft in liver transplantation.
Fifteen Chinese Bama miniature pigs were divided into three groups: group A (small-for-size liver transplantation), group B (distal splenorenal shunt + small-for-size liver transplantation), and group C (mesocaval H-shape shunt + small-for-size liver transplantation). Animals were followed up for 7 days with survival, dynamical liver function biochemical parameters, liver biopsies, portal venous pressure (PVP) and portal blood flow (PBF).
Animal survivals were as follows: group A, 1/5, group B, 3/5 and group C, 5/5.Group A resulted in abnormal liver function parameters that were significantly ameliorated in group B and C. The histological examination of graft in group A displayed severe pathologic changes including hepatocyte vacuolar change or necrosis, sinusoidal congestion, parenchymal hemorrhage. Affiliating portasystemic shunt significantly alleviated graft injuries in group B and C. PVP rose and peaked up to 28.6 mm Hg (1 mm Hg = 0.133 kPa), PBF fluctuated after reperfusion in group A, but group B and C with affiliating portasystemic shunt showed significantly lower PVP and maintained rather stable PBF after reperfusion. There were also statistical differences in PVP or PBF between group B and C.
Affiliating portasystemic shunt effectively might protect small-for-size graft from injuries after reperfusion.
