Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
J Surg Res. 2011 Dec;171(2):486-94. doi: 10.1016/j.jss.2010.04.032. Epub 2010 May 21.
Portal vein embolization (PVE) is a technique to increase future remnant liver volume. A standardized animal model, resembling the clinical PVE procedure, is needed to clarify some of the unresolved issues surrounding PVE. For this purpose we developed a new rabbit model for PVE.
Twenty female New Zealand white rabbits were allocated to two protocols, each containing two subgroups. Eighty percent of the liver portal venous system was embolized with polyvinyl-alcohol particles and coils (protocol 1: 300-500 μm particles and one coil; protocol 2: 90-180 μm combined 300-500 μm particles and three coils). In all rabbits CT-volumetry, ICG clearance test, blood sampling, and portography were performed prior to PVE and at d 7 and 14. Additional blood sampling and CT volumetry was done on d 3 and 7.
PVE was technically feasible in the rabbit. CT-volumetry demonstrated a strong correlation with actual liver weight and volume measured at sacrifice. The hypertrophy response was highest at d 7 in both protocols, which was consistent with the amount of proliferating hepatocytes. Protocol 2 showed less revascularization of the portal venous system and demonstrated the highest hypertrophy response. Comparable to the clinical situation, only a small, transient increase in transaminases was observed. There were no changes in liver function parameters after PVE. Histopathologic findings in the rabbit livers were comparable to those found in human livers.
We successfully devised a rabbit model for PVE, which resembles the human clinical situation.
门静脉栓塞术(PVE)是一种增加未来剩余肝脏体积的技术。需要一种标准化的动物模型,类似于临床 PVE 程序,以澄清围绕 PVE 的一些未解决的问题。为此,我们开发了一种新的兔 PVE 模型。
20 只雌性新西兰白兔被分配到两个方案,每个方案包含两个亚组。80%的肝脏门静脉系统用聚乙烯醇颗粒和线圈栓塞(方案 1:300-500μm 颗粒和一个线圈;方案 2:90-180μm 联合 300-500μm 颗粒和三个线圈)。在所有兔子中,在 PVE 之前以及在第 7 天和第 14 天进行 CT 容积测量、ICG 清除试验、采血和门静脉造影。在第 3 天和第 7 天还进行了额外的采血和 CT 容积测量。
PVE 在兔中是可行的。CT 容积测量与实际肝重和牺牲时测量的肝体积具有很强的相关性。在两个方案中,第 7 天的增生反应最高,这与增殖的肝细胞数量一致。方案 2 显示门静脉系统的再血管化较少,增生反应最高。与临床情况相似,仅观察到转氨酶短暂、轻微升高。PVE 后肝功能参数无变化。兔肝的组织病理学发现与人类肝的发现相似。
我们成功地设计了一种类似于人类临床情况的兔 PVE 模型。