The hepatoprotective effect of hypothermic perfusion of normal saline in period of inflow occlusion of liver in rats.
BACKGROUND
Liver damage in hepatic surgery from warm ischemia and reperfusion (I/R), especially in patients with underlying chronic liver disease, is still challenging. We propose a new method of perfusion of the liver by catheterizing the umbilical vein in the period of hepatic inflow occlusion, and evaluate the influence of transfusion of normal saline (NS) on liver injury in a modified I/R rat model.


METHODS
Twenty-eight rats were randomized into four groups (n=7): group I (sham-operated group): no I/R or transfusion; group II (I/R group): I/R + no transfusion; group III (37°C NS group): I/R + transfusion of 37°C NS ; group IV(24°C NS group): I/R + transfusion of 24°C NS. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), as well as lactate dehydrogenase (LDH) were measured in rat serum. Light and electron microscopic examinations were performed on the liver tissues.


RESULTS
Perfusion of 24°C NS in the period of inflow occlusion resulted in significant reductions of liver enzymes levels compared to the I/R alone group and 37°C NS group (P<0.001 and P<0.001, respectively). Histologic evaluation revealed the injury grade to be relatively lower in group IV compared to group II and III (P<0.001 and P<0.001, respectively).


CONCLUSIONS
This new hypothermic perfusion technique may be very useful in preserving the hepatocytes in hepatic surgery; it is an inexpensive and easy method, which makes it possible to increase its application.
Fu
Xiaohui
X
Eastern Hepatobiliary Surgery Hospital, Shanghai, People's Republic of China.
Lu
Chongde
C
Chu
Kaijian
K
Yao
Xiaoping
X
Cheng
Shuqun
S
Gao
Chunfang
C
Shen
Feng
F
Wu
Mengchao
M
D000410:Alanine Transaminase / Q000378:metabolism; D000818:Animals; D001219:Aspartate Aminotransferases / Q000378:metabolism; D001831:Body Temperature / Q000502:physiology; D002404:Catheterization / Q000379:methods; D004195:Disease Models, Animal; D022781:Hepatocytes / Q000473:pathology / Q000648:ultrastructure; D007036:Hypothermia, Induced / Q000379:methods*; D007770:L-Lactate Dehydrogenase / Q000378:metabolism; D008102:Liver Circulation / Q000502:physiology*; D008107:Liver Diseases / Q000473:pathology / Q000517:prevention & control*; D008297:Male; D008854:Microscopy, Electron; D010477:Perfusion / Q000379:methods; D051381:Rats; D017207:Rats, Sprague-Dawley; D015427:Reperfusion Injury / Q000473:pathology / Q000517:prevention & control*; D012965:Sodium Chloride / Q000494:pharmacology*
D012965:Sodium Chloride; D007770:L-Lactate Dehydrogenase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase