Effect of repeated portal-triad cross-clamping during partial hepatectomy on hepatic regeneration in normal and cirrhotic rats.
The effects of ischemia/reperfusion during 70% partial hepatectomy on hepatic regeneration was evaluated in normal rats and thioacetamide-induced cirrhotic rats. Total hepatic ischemia and reperfusion (15 min each) by portal-triad cross-clamping was repeated two times in normal rats and four times in cirrhotic rats during hepatectomy. The labeling index of hepatocytes on Day 1 after operation (POD) and hepatic regeneration ratio on POD 28 were measured. In normal rats, the repeated ischemia/reperfusion decreased the survival rate from 100 to 77% (P < 0.05), lowered the hepatocyte labeling index from 33.5 +/- 2.5 to 16.7 +/- 6.5%, and diminished the hepatic regeneration ratio from 199 +/- 17 to 137 +/- 12% (P < 0.01). However, portal-systemic shunt improved those levels to 100, 30.6 +/- 13.7, and 169 +/- 19%, respectively (P < 0.01). In cirrhotic rats, no portal congestion was observed and hepatic regeneration was not suppressed by ischemia/reperfusion. Thus, portal pooling and the reperfusion of pooled portal blood may be the cause of inhibition on hepatic regeneration and not ischemia/reperfusion of the liver itself. Therefore, repeated portal-triad cross-clamping for short periods of time during the resection of cirrhotic liver is not harmful for hepatic regeneration.
Usami
M
M
First Department of Surgery, Kobe University School of Medicine, Japan.
Furuchi
K
K
Shiroiwa
H
H
Saitoh
Y
Y
D000818:Animals; D003250:Constriction; D004247:DNA / Q000096:biosynthesis; D006498:Hepatectomy / Q000379:methods*; D007511:Ischemia / Q000473:pathology / Q000503:physiopathology; D008099:Liver / Q000098:blood supply / Q000378:metabolism / Q000473:pathology; D008106:Liver Cirrhosis, Experimental / Q000473:pathology / Q000503:physiopathology*; D008115:Liver Regeneration / Q000502:physiology*; D008297:Male; D011169:Portal Vein / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011170:Portasystemic Shunt, Surgical; D011172:Portography; D051381:Rats; D017208:Rats, Wistar; D015427:Reperfusion Injury / Q000473:pathology / Q000503:physiopathology
D004247:DNA