International journal of surgery (London, England) · 2025
Cross-circulation combined with rapidly deployable venovenous bypass grafts for multiorgan biosystemic support in liver failure: experimental studies.
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Liu Peng, Yang Lifei, Lu Qiang, Qian Yerong, Shi Aihua, Liu Xin, Wei Shasha, Fan Shujuan, Lv Yi, Xiang Junxi
Аннотация
BACKGROUND: Liver failure remains a critical clinical challenge with limited treatment options. Cross-circulation, the establishment of vascular connections between individuals, has historically been explored as a potential supportive therapy but with limited success. This study investigated the feasibility of combining cross-circulation with a rapidly deployable venovenous bypass (VVB) graft for multiorgan support in a rat model of total hepatectomy, representing the most severe form of liver failure.
MATERIALS AND METHODS: A Y-shaped VVB graft was fabricated using coaxial electrospinning of PLCL/heparin nanofibers and magnetic rings for rapid anastomosis. After total hepatectomy in rats, the VVB graft was implanted to divert blood flow. Cross-circulation was then established between anhepatic and normal host rats. Hemodynamics, biochemical parameters, blood gases, and survival were analyzed across three groups: hepatectomy with blocked vessels (block group), hepatectomy with VVB only (VVB group), and hepatectomy with VVB and cross-circulation (VVB/cross-circulation group).
RESULTS: The VVB graft exhibited suitable mechanical properties and hemocompatibility. VVB rapidly restored hemodynamic stability and mitigated abdominal congestion posthepatectomy. Cross-circulation further ameliorated liver dysfunction, metabolic derangements, and coagulation disorders in anhepatic rats, significantly prolonging survival compared to the VVB group (mean 6.56±0.58 vs. 4.05±0.51 h, P <0.05) and the block group (mean 1.01±0.05 h, P <0.05).
CONCLUSION: Combining cross-circulation with a rapidly deployed VVB graft provided effective multiorgan biosystemic support in a rat model of total hepatectomy, substantially improving the biochemical status and survival time. This approach holds promise for novel liver failure therapies and could facilitate liver transplantation procedures.
MATERIALS AND METHODS: A Y-shaped VVB graft was fabricated using coaxial electrospinning of PLCL/heparin nanofibers and magnetic rings for rapid anastomosis. After total hepatectomy in rats, the VVB graft was implanted to divert blood flow. Cross-circulation was then established between anhepatic and normal host rats. Hemodynamics, biochemical parameters, blood gases, and survival were analyzed across three groups: hepatectomy with blocked vessels (block group), hepatectomy with VVB only (VVB group), and hepatectomy with VVB and cross-circulation (VVB/cross-circulation group).
RESULTS: The VVB graft exhibited suitable mechanical properties and hemocompatibility. VVB rapidly restored hemodynamic stability and mitigated abdominal congestion posthepatectomy. Cross-circulation further ameliorated liver dysfunction, metabolic derangements, and coagulation disorders in anhepatic rats, significantly prolonging survival compared to the VVB group (mean 6.56±0.58 vs. 4.05±0.51 h, P <0.05) and the block group (mean 1.01±0.05 h, P <0.05).
CONCLUSION: Combining cross-circulation with a rapidly deployed VVB graft provided effective multiorgan biosystemic support in a rat model of total hepatectomy, substantially improving the biochemical status and survival time. This approach holds promise for novel liver failure therapies and could facilitate liver transplantation procedures.