2019, Number 1
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Ann Hepatol 2019; 18 (1)
Effect of Portal Vein Ligation Plus Venous Congestion on Liver Regeneration in Rats
Kawaguchi D, Hiroshima Y, Kumamoto T, Mori R, Matsuyama R, Ichikawa Y, Inayama Y, Endo I
Language: English
References: 27
Page: 89-100
PDF size: 1596.36 Kb.
ABSTRACT
Introduction and aim. We developed a rat model of portal vein ligation (PVL) with venous congestion (PVL+C) to investigate
beneficial effect PVL plus congestion for regeneration of intact liver segments.
Materials and methods. In the PVL group, portal
vein branches were ligated except the caudate lobe (CL). In the PVL + C group, the left lateral hepatic vein was ligated in addition to
PVL. Chronological changes in the following variables were compared among the groups: CL weight to body weight ratio (CL/BW),
embolized liver weight to body weight ratio (EL/BW), histological findings of the embolized/non-embolized liver, and expression of
several mediators that affect liver regeneration in the non-embolized liver.
Results. Weight regeneration of CL continued up to postoperative
day (POD)7 in PVL + C, but terminated at POD2 in PVL. CL/BW at POD7 was significantly higher in PVL + C than in
PVL (2.41 ± 0.33%
vs. 1.22 ± 0.18%, P ‹ 0.01). In contrast, EL/BW continued to decrease up to POD7 in PVL + C but reached
nadir at POD2 in PVL. Furthermore, EL/BW at POD7 was significantly smaller in PVL + C than in PVL (0.35 ± 0.03%
vs. 0.67 ±
0.08%, P ‹ 0.01). Histologically-proven injury in the embolized liver was more severe in PVL + C than in PVL. Expression of Ki-67,
IL-6, TNF-α, and HGF were greater and/or more prolonged in PVL + C than in PVL.
Conclusions. Our rat model of PVL + C was
considered useful for investigating the beneficial effect of congestion in addition to PVC. PVL + C caused increased devastation of
the embolized liver, and higher and more prolonged expression of factors promoting liver regeneration in the non-embolized liver than
in PVL.
REFERENCES
Nagorney DM, van Heerden JA, Ilstrup DM, Adson MA. Primary hepatic malignancy: surgical management and determinants of survival. Surgery 1989; 106: 740-8.
Hughes KS, Rosenstein RB, Songhorabodi S, Adson MA, Ilstrup DM, Fortner JG, Maclean BJ, et al. Resection of the liver for colorectal carcinoma metastases. A multi-institutional study of long-term survivors. Dis Colon Rectum 1988; 31: 1-4.
Yasuji S, Masatoshi M. Current surgical treatment for bile duct cancer. World J Gastroenterol 2007; 13: 1505-15.
Ueda A, Yoshidome H, Kaqawa S, Greget M, Weber JC, Bachellier P. Two-stage hepatectomy procedure combined with portal vein embolization to achieve curative resection for initially unresectable multiple and bilobar colorectal liver metastases. Ann Surg 2004; 240: 1037-49.
Azouley D, Castaing D, Smail A, Adam R, Cailliez V, Laurent A, Lemoine A, et al. Resection of nonresectable liver metastases from colorectal cancer after percutaneous portal vein embolization. Ann Surg 2000; 231: 480-6.
Makuuchi M, Thai BL, Takayasu K, Takayama T, Kosuge T, Gunvén P, Yamazaki S, et al. Preoperative portal embolization to increase safety of major hepatectomy for hilar bile duct carcinoma: a preliminary report. Surg 1990; 107: 521-7.
Di Stefano DR, de Baere T, Denys A, Hakime A, Gorin G, Gillet M, Saric J, et al. Preoperative percutaneous portal vein embolization: evaluation of adverse events in 188 patients. Radiology 2005; 234: 625-30.
de Santibañes E, Clavien PA. Playing Play-Doh to prevent postoperative liver failure: the “ALPPS” approach. Ann Surg 2012; 255: 415-7.
Alvarez FA, Ardiles V, Sanchez Claria R, Pekolj J, de Santibañes E. Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS): tips and tricks. J Gastrointest Surg 2013; 17: 814-21.
Ratti F, Cipriani F, Gagliano A, Catena M, Paganelli M, Aldrighetti L. Defining indications to alpps procedure: technical aspects and open issues. Updates Surg 2014; 66: 41-9.
Mikhail S, Cosgrove D, Zeidan A. Hepatocellular carcinoma: systemic therapies and future perspectives. Expert Rev Anticancer Ther 2014; 14: 1205-18.
12 Hwang S, Lee SG, Ko GY, Kim BS, Sung KB, Kim MH, Lee SK, et al. Sequential preoperative ipsilateral hepatic vein embolization after portal vein embolization to induce further liver regeneration in patients with hepatobiliary malignancy. Ann Surg 2009; 249: 608-16.
Nagano Y, Nagahori K, Kamiyama M, Fujii Y, Kubota T, Endo I, Togo S, et al. Improved functional reserve of hypertrophied contralateral liver after portal vein ligation in rats. J Hepatol 2002; 37: 72-7.
Mizuno S, Mimura Y, Suzuki H, Yoshida S. Portal vein branch occlusion induces cell proliferation of cholestatic rat liver. J Surg Res 1996; 60: 249-57.
Morioka D, Tanaka K, Sekido H, Matsuo K, Sugita M, Ueda M, Endo I, et al. Disruption of the middle hepatic vein is not crucial for liver regeneration of the remnant liver after right hemihepatectomy for hepatic tumors. Ann Surg Oncol 2006; 13: 1560-8.
Michalopoulos GK. Liver regeneration. J Cell Physiol 2007; 213: 286-300.
Diehl AM, Yin M, Fleckenstein J, Yang SQ, Lin HZ, Brenner DA, Westwick J, et al. Tumor necrosis factor-alpha induces c-jun during the regenerative response to liver injury. Am J Physiol 1994; 267: G552-61.
Fujiyoshi M, Ozaki M. Molecular mechanisms of liver regeneration and protection for treatment of liver dysfunction and diseases. J Hepatobiliary Pancreat Sci 2012; 18: 13-22.
Pahlavan PS, Feldmann RE Jr, Zavos C, Kountouras J. Prometheus’ challenge: molecular, cellular and systemic aspects of liver regeneration. J Surg Res 2006; 134: 238-51.
Taub R. Liver regeneration: from myth to mechanism. Nat Rev Mol Cell Biol 2004; 5: 836-47.
Hsu MK, Qiao L, Ho V, Zhang BH, Zhang H, Teoh N, Dent P, et al. Ethanol reduces p38 kinase activation and cyclin D1 protein expression after partial hepatectomy in rats. J Hepatol 2006; 44: 375-82.
Fausto N. Liver regeneration. J Hepatol 2000; 32: 19-31.
Klune JR, Dhupar R, Cardinal J, Billiar TR, Tsung A. HMGB1: endogenous danger signaling. Mol Med 2008; 14: 476-84.
Sakamoto Y, Inagaki F, Omichi K, Ohkura N, Hasegawa K, Kokudo N. Associating liver partial partition and transileocecal portal vein embolization for staged hepatectomy. Ann Surg 2016; 264: e21-22.
Morioka D, Watanabe K, Makino H, Saito S, Ueda M, Kubota T, Sekido H, et al. Safety limit of the extent of hepatectomy for rats with moderately fatty liver: Experimental study concerning living liver donor safety. J Gastroenterol Hepatol 2006; 21: 367-73.
Yokoyama S, Yokoyama Y, Kawai T, Kobayashi S, Nagino M, Oda K, Nimura Y, et al. Biphasic activation of liver regeneration- associated signals in an early stage after portal vein branch ligation. Biochem Biophys Res Commun 2006; 349: 732-9.
Kobayashi S, Nagino M, Yokoyama Y, Nimura Y, Sokabe M. Evaluation of hepatic interleukin-6 secretion following portal vein ligation using a minimal surgical stress model. J Surgical Research 2006; 135: 27-33.