Portal hyperperfusion causes disturbance of microcirculation and increased rate of hepatocellular apoptosis: investigations in heterotopic rat liver transplantation with portal vein arterialization

Transplantation Proceedings
Karina SchleimerK Tobias E Beckurts

Abstract

Clinical results of portal vein arterialization (PVA) in liver transplantation are controversial. One reason for this is the lack of a standardized flow regulation. Our experiments in rats compared PVA with blood-flow regulation to PVA with hyperperfusion in heterotopic auxiliary liver transplantation (HALT). In group I (n = 19), the graft's portal vein was completely arterialized via the right renal artery in-stent technique, using a 0.3-mm stent, leading to a physiological average portal blood flow. In group II (n = 19), a 0.5-mm stent was used. In group II, the average portal blood flow after reperfusion was significantly elevated (group II: 6.4 +/- 1.5; group I: 1.7 +/- 0.4 mL/min/g of liver weight; P < .001). The sinusoidal diameter after reperfusion was significantly greater in group II (9.8 +/- 0.5 microm) than in group I (5.5 +/- 0.2 microm; P < .001). Red blood cell velocity in the dilated sinusoids was significantly lower in group II (171 +/- 18 microm/s) than in group I (252 +/- 13 microm/s). Stasis of erythrocytes occurred; consequently, the functional sinusoidal density was significantly reduced in group II (38 +/- 7%) compared with group I (50 +/- 3%; P < .01). Two hours after reperfusion of the portal vein, the n...Continue Reading

References

Apr 30, 1998·Transplant International : Official Journal of the European Society for Organ Transplantation·R TroisiB de Hemptinne
Nov 21, 2000·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·C MargaritE Murio
Jul 9, 2002·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·R CharcoI Bilbao
Mar 12, 2004·The Journal of Surgical Research·Karina SchleimerK Tobias E Beckurts

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Citations

Jul 5, 2008·The Journal of Surgical Research·Karina SchleimerK Tobias E Beckurts
Dec 19, 2009·Journal of Veterinary Emergency and Critical Care·Deborah C SilversteinKenneth J Drobatz
Dec 22, 2011·European Journal of Gastroenterology & Hepatology·Jianguo QiuYong Zeng
Sep 19, 2014·World Journal of Gastroenterology : WJG·Kun ZhangXiao-Jin Zhang

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Apoptosis

Apoptosis is a specific process that leads to programmed cell death through the activation of an evolutionary conserved intracellular pathway leading to pathognomic cellular changes distinct from cellular necrosis