Liska Vaclav, Treska Vladislav, Mirka Hynek, Kobr Jiri, Sykora Roman, Skalicky Tomas, Sutnar Alan, Bruha Jan, Fiala Ondrej, Vycital Ondrej, Chlumska Alena, Holubec Lubos, Kormunda Stanislav, Trefil Ladislav, Racek Jaroslav, Matejovic Martin
Department of Surgery, Charles University, Prague, Czech Republic.
Hepatogastroenterology. 2012 Mar-Apr;59(114):496-500. doi: 10.5754/hge10265.
BACKGROUND/AIMS: Portal vein ligation (PVL) could multiply the future liver remnant volume (FLRV). Tumor necrosis factor- alpha (TNF-α) is a pleiotropic cytokine that is connected with initial phase of liver regeneration. The aim of this basic pilot study was to accelerate regeneration of liver parenchyma after PVL. The experimental porcine model was developed to be as much compatible as possible with portal vein embolization (PVE) in human medicine.
After ligation of portal branches of caudate and right lateral and right medial liver lobes recombinant porcine TNF-α (TNF-α group) or physiological solution (control group) were applied into non-occluded portal vein branches. The biochemical and immunoanalytical parameters were assessed. The compensatory hypertrophy was evaluated by periodic ultrasonography. The histological examination of liver was performed.
The acceleration of growth of hypertrophic liver lobes was maximal at the 7th postoperative day in comparison with the control group (p<0.05); nevertheless this stimulating effect was lost at the end of experiment. The important differences in biochemical or histological studied parametres between study groups were not proved.
The achieved acceleration of growth of hypertrophic liver lobes after application of TNF-α confirms the role of studied cytokine in priming of liver regeneration.
背景/目的：门静脉结扎术（PVL）可增加未来肝脏剩余体积（FLRV）。肿瘤坏死因子-α（TNF-α）是一种多效性细胞因子，与肝再生的初始阶段相关。这项基础初步研究的目的是加速PVL术后肝实质的再生。建立的实验猪模型尽可能与人类医学中的门静脉栓塞术（PVE）兼容。
在结扎尾状叶、右外侧叶和右内侧叶的门静脉分支后，将重组猪TNF-α（TNF-α组）或生理盐水（对照组）注入未闭塞的门静脉分支。评估生化和免疫分析参数。通过定期超声检查评估代偿性肥大。对肝脏进行组织学检查。
与对照组相比，肥大肝叶生长加速在术后第7天最大（p<0.05）；然而，这种刺激作用在实验结束时消失。未证实研究组之间在生化或组织学研究参数上存在重要差异。
应用TNF-α后肥大肝叶生长加速，证实了所研究的细胞因子在启动肝再生中的作用。
