title: Portal vein arterialisation as a technical option in liver transplantation: impact on function, regeneration, and morphology of the liver following hemihepatectomy in pigs.
abstract: BACKGROUND
  Arterialisation of the portal vein has been propagated as a technical variant in liver transplantation. However, the consequences of this unphysiological vascular supply are insufficiently known.
  
  
  METHODS
  Twenty-seven healthy pigs were subjected to a left hemihepatectomy and divided into three groups. The first group received complete arterialisation of the portal vein (PVA). In the second group hepatic artery blood flow was also interrupted by dividing the artery (PVA/DHA). Nine animals served as controls (Group C).
  
  
  RESULTS
  Early mortality in the PVA/DHA group (6/9) was significantly increased in comparison with the PVA (2/9) and control (2/9) groups (P < 0.05). In the surviving animals, arterialisation (PVA and PVA/DHA) led to significantly faster hepatic regeneration in comparison with control animals, with comparable liver function and with liver size increasing to 278% and 293% vs 134% (P = 0.002) after 3 weeks, in liver ... weeks. This was accompanied by enhanced hepatic expression of the proliferation markers MIB-1 (22.4% and 16.7% vs 5.9%, P = 0.002) and PCNA (86% and 68% vs 66%, P = 0.002) one week postoperation. At the same time, the number of apoptotic hepatocytes increased from 1.6% to 2.5% and 2.3% (P = 0.002). No significant difference was found in the collagen content of the liver after 3 weeks.
  
  
  CONCLUSIONS
  Arterialisation of the portal vein promotes early and enhanced hepatic regeneration without impairing liver function. This technique may therefore be useful in split-graft liver transplantation, where this aspect would be of particular importance.
authors.affiliation: Department of Surgery, University of Leipzig, Leipzig, Germany. Rudolf.Ott@rzmail.uni-erlangen.de
authors.forename: Rudolf
authors.initials: R
authors.lastname: Ott
authors.forename: Detlef
authors.initials: D
authors.lastname: Schuppan
authors.forename: Andrea
authors.initials: A
authors.lastname: Tannapfel
authors.forename: Christian
authors.initials: C
authors.lastname: Wittekind
authors.forename: Wolf
authors.initials: W
authors.lastname: Erhardt
authors.forename: Julia
authors.initials: J
authors.lastname: Henke
authors.forename: Nu
authors.initials: N
authors.lastname: Kilic
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Köckerling
authors.forename: Thomas
authors.initials: T
authors.lastname: Reck
authors.forename: Werner
authors.initials: W
authors.lastname: Hohenberger
authors.forename: Volker
authors.initials: V
authors.lastname: Müller
mesh_terms: D000818:Animals; D017209:Apoptosis; D001219:Aspartate Aminotransferases / Q000097:blood; D001783:Blood Flow Velocity; D006498:Hepatectomy; D019394:Ki-67 Antigen / Q000378:metabolism; D008099:Liver / Q000033:anatomy & histology / Q000098:blood supply / Q000502:physiology*; D008102:Liver Circulation / Q000502:physiology*; D008115:Liver Regeneration / Q000502:physiology*; D016031:Liver Transplantation / Q000379:methods*; D023421:Models, Animal; D011169:Portal Vein / Q000502:physiology / Q000601:surgery*; D018809:Proliferating Cell Nuclear Antigen / Q000378:metabolism; D013552:Swine; D013997:Time Factors
chemical_list: D019394:Ki-67 Antigen; D018809:Proliferating Cell Nuclear Antigen; D001219:Aspartate Aminotransferases