Extracorporeal portal vein oxygenation improves outcome of acute liver failure in swine.
BACKGROUND
Portal vein arterialization (PVA) has shown efficacy to treat acute liver failure (ALF) in preclinical studies. The next step is to perform large animal studies that propose a clinically acceptable method of PVA. In this study, we assessed the efficacy of PVA using an extracorporeal device to treat 2 ALF models in swine.


METHODS
The 2 ALF swine models were carbon tetrachloride toxic ALF and subtotal hepatectomy using 8 animals per group. PVA was performed with an extracorporeal device that may be suitable for future clinical studies. Arterial blood was drawn from the iliac artery and delivered into the portal vein for a 6-hour treatment. We analyzed biochemical, blood gas, and histological parameters as well as 1-week survival rates.


RESULTS
In both models, ALF was successfully achieved. Control group animals deteriorated biochemically, dropping their prothrombin times and increasing the liver enzymes. In contrast, treated animals improved with a survival rate of 75% at 7 days compared with 0% for the former group.


CONCLUSIONS
PVA using an extracorporeal device was feasible and effective to treat both toxic and resective ALF in swine.
Nardo
B
B
Department of General Surgery and Transplantations, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. bruno.nardo@unibo.it
Tsivian
M
M
Neri
F
F
Piras
G
G
Pariali
M
M
Bertelli
R
R
Cavallari
G
G
D000818:Animals; D004195:Disease Models, Animal; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D006498:Hepatectomy; D006499:Hepatic Artery; D008102:Liver Circulation / Q000502:physiology; D017114:Liver Failure, Acute / Q000628:therapy*; D011168:Portal System; D011169:Portal Vein; D013552:Swine; D016896:Treatment Outcome