title: Partial hepatic grafting: porcine study on critical volume reduction.
abstract: BACKGROUND
  The safe limit of volume reduction in partial hepatic transplantation, including extracorporeal hepatic resection, remains to be clarified. This study evaluated such a limit and pathologic features associated with transplantation of a less than critical volume.
  
  
  METHODS
  Partial hepatic grafting was performed in a porcine orthotopic autotransplantation model. According to the remnant liver volume, animals were classified into three groups: group 1, 73.8% +/- 4.2% (SD); group 2, 52.6% +/- 6.7%; and group 3, 29.4% +/- 6.7% of the whole liver (n = 5 each).
  
  
  RESULTS
  Three-day survival was achieved in five (100%), four (80%), and zero animals, respectively. All animals in group 3 died of graft nonfunction; their intraoperative clearance of the total bile acids was significantly worse than the other groups (p < 0.01). After operation the clearance of the total bile acids and hyaluronic acid, which is selectively cleared by hepatic endothelial cells, was significantly better in group 1 than group 2 (p < 0.01 and < 0.05, respectively). On histologic examination postperfusion biopsy specimens of group 3 exhibited severe ischemic changes and portosinusoidal hyperemia, whereas that of groups 1 and 2 exhibited only mild ischemic damages.
  
  
  CONCLUSIONS
  Transplantation of less than 30% of expected full liver volume could lead to primary graft nonfunction after partial hepatic grafting.
authors.affiliation: Department of Surgery II, Kyushu University Faculty of Medicine, Fukuoka, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Yanaga
authors.forename: K
authors.initials: K
authors.lastname: Kishikawa
authors.forename: T
authors.initials: T
authors.lastname: Suehiro
authors.forename: T
authors.initials: T
authors.lastname: Nishizaki
authors.forename: M
authors.initials: M
authors.lastname: Shimada
authors.forename: H
authors.initials: H
authors.lastname: Itasaka
authors.forename: K
authors.initials: K
authors.lastname: Nomoto
authors.forename: S
authors.initials: S
authors.lastname: Kakizoe
authors.forename: K
authors.initials: K
authors.lastname: Sugimachi
mesh_terms: D000818:Animals; D001647:Bile Acids and Salts / Q000097:blood; D005260:Female; D008099:Liver / Q000473:pathology; D016031:Liver Transplantation / Q000379:methods*; D013552:Swine
chemical_list: D001647:Bile Acids and Salts