title: Development of a porcine model of post-hepatectomy liver failure.
abstract: BACKGROUND
  The aim of this study was to develop a porcine model of post-operative liver failure (POLF) that could accurately reproduce all the neurological and metabolic parameters of the corresponding clinical syndrome that may develop after extensive liver resections.
  
  
  METHODS
  In our model, we induced POLF by combining extended left hepatectomy and ischemia of the small liver remnant of 150 min duration. Subsequently, the remnant liver parenchyma was reperfused and the animals were closely monitored for 24 h.
  
  
  METHODS
  Twelve Landrace pigs (weight 25-30 kg) were randomly assigned in two groups; eight of them constituted the experimental group, in which POLF was induced (POLF group, n = 8), whereas the rest of them (n = 4) were included in the control group (sham laparotomy without establishment of POLF). RESULTS (MEANS ± SD): All POLF animals gradually developed neurological and biochemical signs of liver failure including, among many other parameters, elevated intracranial pressure (24.00 ± 4.69 versus 10.17 ± 0.75, P = 0.004) and ammonia levels (633.00 ± 252.21 versus 51.50 ± 9.49, P = 0.004) compared with controls. Histopathologic evaluation of the liver at the end of the experiment demonstrated diffuse coagulative necrosis and severe architectural distortion of the hepatic parenchyma in all POLF animals.
  
  
  CONCLUSIONS
  Our surgical technique creates a reproducible porcine model of POLF which can be used to study the pathophysiology and possible therapeutic interventions in this serious complication of extensive hepatectomies.
authors.affiliation: 4th Department of Surgery, University of Athens Medical School, Attikon Hospital, Chaidari, Athens, Greece. narkado@otenet.gr
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Arkadopoulos
authors.forename: Georgios
authors.initials: G
authors.lastname: Defterevos
authors.forename: Constantinos
authors.initials: C
authors.lastname: Nastos
authors.forename: Apostolos
authors.initials: A
authors.lastname: Papalois
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Kalimeris
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Papoutsidakis
authors.forename: Georgios
authors.initials: G
authors.lastname: Kampouroglou
authors.forename: Dimosthenis
authors.initials: D
authors.lastname: Kypriotis
authors.forename: Agathi
authors.initials: A
authors.lastname: Pafiti
authors.forename: Georgia
authors.initials: G
authors.lastname: Kostopanagiotou
authors.forename: Vassilios
authors.initials: V
authors.lastname: Smyrniotis
mesh_terms: D000641:Ammonia / Q000097:blood; D000818:Animals; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure / Q000502:physiology; D001835:Body Weight; D004195:Disease Models, Animal; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects* / Q000379:methods; D007427:Intracranial Pressure / Q000502:physiology; D008099:Liver / Q000473:pathology / Q000601:surgery; D017114:Liver Failure, Acute / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D009336:Necrosis; D011167:Portacaval Shunt, Surgical / Q000009:adverse effects / Q000379:methods; D011183:Postoperative Complications / Q000473:pathology* / Q000503:physiopathology; D015427:Reperfusion Injury / Q000473:pathology / Q000503:physiopathology; D034421:Sus scrofa
chemical_list: D015415:Biomarkers; D000641:Ammonia