Successful treatment of CCL4-induced acute liver failure with portal vein arterialization in the rat.
BACKGROUND
Optimization of the conditions for regeneration of the native diseased liver is a major goal in patients with acute liver failure. This study sought to determine whether portal vein arterialization (PVA), which increases the oxygen supply to the liver, was protective in a rat model of liver failure.


METHODS
At 24 hours after CCl(4) intoxication, Sprague-Dawley rats (six per group) were assigned to receive PVA or as controls. We determined blood tests, histology, and 10-day survivals. Hepatocyte regeneration was assessed by the mitotic index and bromodeoxyuridine (BrdU) incorporation.


RESULTS
Serum transaminases were significantly lower in PVA-treated rats than in control animals: liver necrosis resolved rapidly after PVA. The BrdU staining and mitotic index were severalfold higher among PVA-treated than in untreated rats. Survival was 100% among rats with PVA and 40% in untreated animals (P < .01).


CONCLUSIONS
PVA led to resolution of CCl(4)-induced massive liver necrosis in the rat. This effect was probably mediated by activation of rapid and extensive hepatocyte regeneration. PVA might provide a novel, alternative approach to treat acute liver failure.
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
Pacilè
V
V
Bertelli
R
R
Beltempo
P
P
Cavallari
G
G
Chieco
P
P
Pariali
M
M
Pertosa
A M
AM
Angiolini
G
G
Domenicali
M
M
Neri
F
F
Tsivian
M
M
Bernardi
M
M
Cavallari
A
A
D000410:Alanine Transaminase / Q000097:blood; D000818:Animals; D001219:Aspartate Aminotransferases / Q000097:blood; D002252:Carbon Tetrachloride Poisoning / Q000601:surgery*; D004195:Disease Models, Animal; D008102:Liver Circulation; D017093:Liver Failure / Q000601:surgery*; D008111:Liver Function Tests; D008297:Male; D011169:Portal Vein / Q000601:surgery*; D011517:Prothrombin Time; D051381:Rats; D017207:Rats, Sprague-Dawley
D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase