[Protective effects of affiliating portasystemic shunt on graft injury in small-for-size liver transplantation in miniature pigs].
OBJECTIVE
To evaluate the protective effects of affiliating portasystemic shunt on small-for-size graft in liver transplantation.


METHODS
Fifteen Chinese Bama miniature pigs were divided into three groups: group A (small-for-size liver transplantation), group B (distal splenorenal shunt + small-for-size liver transplantation), and group C (mesocaval H-shape shunt + small-for-size liver transplantation). Animals were followed up for 7 days with survival, dynamical liver function biochemical parameters, liver biopsies, portal venous pressure (PVP) and portal blood flow (PBF).


RESULTS
Animal survivals were as follows: group A, 1/5, group B, 3/5 and group C, 5/5.Group A resulted in abnormal liver function parameters that were significantly ameliorated in group B and C. The histological examination of graft in group A displayed severe pathologic changes including hepatocyte vacuolar change or necrosis, sinusoidal congestion, parenchymal hemorrhage. Affiliating portasystemic shunt significantly alleviated graft injuries in group B and C. PVP rose and peaked up to 28.6 mm Hg (1 mm Hg = 0.133 kPa), PBF fluctuated after reperfusion in group A, but group B and C with affiliating portasystemic shunt showed significantly lower PVP and maintained rather stable PBF after reperfusion. There were also statistical differences in PVP or PBF between group B and C.


CONCLUSIONS
Affiliating portasystemic shunt effectively might protect small-for-size graft from injuries after reperfusion.
Institute of Hepatobiliary Surgery, General Hospital of Chinese People's Liberation Army, Beijing 100853, China.
Jian-jun
JJ
Leng
Jia-hong
JH
Dong
Ben-li
BL
Han
Shu-guo
SG
Zheng
Huai-zhi
HZ
Wang
D000818:Animals; D005260:Female; D008099:Liver / Q000473:pathology; D016031:Liver Transplantation; D008297:Male; D023421:Models, Animal; D017082:Portal Pressure; D011169:Portal Vein / Q000502:physiology; D011170:Portasystemic Shunt, Surgical / Q000379:methods*; D011897:Random Allocation; D012039:Regional Blood Flow; D015996:Survival Rate; D013552:Swine; D013556:Swine, Miniature