Technical aspects of portal vein arterialization for acute liver failure: from rat lab to man.
Survival rates of patients with acute liver failure (ALF) without transplantation are poor. However, many of them die awaiting a transplant because of the donor organ shortage. Supporting these patients until an organ becomes available or until their own liver is able to regenerate itself thus avoiding transplantation is a major goal in their multidisciplinary treatment. Animal experimental studies have shown that portal vein arterialization (PVA) enhances the regenerative capacity of hepatocytes by increasing the oxygen supply to the liver after extended hepatectomy or in toxin-induced ALF models. Furthermore, we have reported the application of PVA in patients with ALF. We herein have described the technical aspects of the PVA procedure both in preclinical models and in man.
Nardo
B
B
Department of Surgery and Transplantations, S. Orsola-Malpighi Hospital, University of Bologna, Italy. nardo@aosp.bo.it
Puviani
L
L
Caraceni
P
P
Montalti
R
R
Pacilè
V
V
Bertelli
R
R
Beltempo
P
P
Cavallari
G
G
Pariali
M
M
Angiolini
G
G
Domenicali
M
M
Neri
F
F
Prezzi
D
D
Tsivian
M
M
Chieco
P
P
Cavallari
A
A
D000208:Acute Disease; D000328:Adult; D000818:Animals; D002245:Carbon Dioxide / Q000097:blood; D002648:Child; D004195:Disease Models, Animal; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008102:Liver Circulation; D017093:Liver Failure / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D010100:Oxygen / Q000097:blood; D010313:Partial Pressure; D011169:Portal Vein / Q000601:surgery*; D051381:Rats; D017207:Rats, Sprague-Dawley; D014850:Waiting Lists
D002245:Carbon Dioxide; D010100:Oxygen