title: Effect of the portacaval shunt on reperfusion injury after 65% hepatectomy in pigs.
abstract: BACKGROUND
  Portal flow diversion by portacaval shunts (PCS) has been shown to prevent primary graft nonfunction in liver transplantation using small-for-size grafts. In this study, we examine whether PCS can improve reperfusion injury after major hepatectomy in pigs.
  
  
  METHODS
  In 14 pigs, a partial PCS was constructed following 65% hepatectomy and 1 h of inflow ischemia. During 24 h of reperfusion, the shunt was either closed (group A, n = 7) or left open (group B, n = 7).
  
  
  RESULTS
  24 h after reperfusion, group A had higher levels of alanine aminotransferase (70 +/- 12 IU/l vs. 51 +/- 5.9 IU/l; p < 0.05), alanine aminotransferase per gram of liver remnant (0.41 +/- 0.07 IU/l/g vs. 0.21 +/- 0.05 IU/l/g; p < 0.05), prothrombin time (24.1 +/- 2.4 s vs. 14.3 +/- 2.9 s; p < 0.05), international normalized ratio (2.11 +/- 0.15 vs. 1.29 +/- 0.28; p < 0.05), hepatocyte necrosis scores and percentages of nuclei stained for proliferating cell nuclear antigen (52.57 +/- 8.9% vs. 36.71 +/- 6%; p < 0.05) compared to group B.
  
  
  CONCLUSIONS
  Partial portal flow diversion appears to attenuate reperfusion injury in a porcine model of major hepatectomy.
authors.affiliation: Second Department of Surgery, Athens University School of Medicine, Aretaieion University Hospital, Athens, Greece.
authors.forename: C
authors.initials: C
authors.lastname: Farantos
authors.forename: N
authors.initials: N
authors.lastname: Arkadopoulos
authors.forename: K
authors.initials: K
authors.lastname: Theodoraki
authors.forename: G
authors.initials: G
authors.lastname: Kostopanagiotou
authors.forename: K
authors.initials: K
authors.lastname: Katis
authors.forename: K
authors.initials: K
authors.lastname: Tzavara
authors.forename: I
authors.initials: I
authors.lastname: Andreadou
authors.forename: K
authors.initials: K
authors.lastname: Dimopoulou
authors.forename: E
authors.initials: E
authors.lastname: Hatzoudi
authors.forename: T
authors.initials: T
authors.lastname: Sidiropoulou
authors.forename: I
authors.initials: I
authors.lastname: Skalkidis
authors.forename: A
authors.initials: A
authors.lastname: Paphiti
authors.forename: V
authors.initials: V
authors.lastname: Smyrniotis
mesh_terms: D000818:Animals; D006498:Hepatectomy / Q000009:adverse effects*; D008099:Liver / Q000473:pathology; D011167:Portacaval Shunt, Surgical; D011897:Random Allocation; D015427:Reperfusion Injury / Q000097:blood / Q000473:pathology / Q000517:prevention & control*; D013552:Swine; D052096:Warm Ischemia / Q000009:adverse effects*