Effect of the portacaval shunt on reperfusion injury after 65% hepatectomy in pigs.

BACKGROUND

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.

MATERIALS AND

METHODS

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).

RESULTS

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.

CONCLUSIONS

Partial portal flow diversion appears to attenuate reperfusion injury in a porcine model of major hepatectomy.