Short-term effects of combined hepatic vein embolization and portal vein embolization for the induction of liver regeneration in a rabbit model.
OBJECTIVE
Alternative methods to optimize the hypertrophy response after portal vein embolization (PVE) are desired. This study assessed the effect of hepatic vein embolization (HVE) in addition to PVE on liver hypertrophy response in a standardized rabbit model.


METHODS
Thirty rabbits were allocated to groups according to intervention: PVE alone, HVE alone, and a combination of HVE and PVE. The liver regeneration response of the nonembolized, caudal liver was assessed by computed tomographic volumetry, liver-to-body weight index, and the amount of proliferating hepatocytes.


RESULTS
The caudal liver volume (CLV) increased significantly more in the PVE and combined PVE/HVE group than in the HVE group at 3 and 7 days after the procedure (P < .01). There were no significant differences in CLV increase or degree of hypertrophy between the PVE and combined embolization groups. The caudal liver-to-body weight index was significantly higher in the PVE and combined embolization groups than in the HVE group on day 7 (P < .01). The index was also significantly higher in the combined PVE/HVE group compared with the PVE group (P = .008). The caudal liver tissue of the PVE and combined groups contained a significantly higher number of proliferating hepatocytes compared with the HVE group on day 7 (P < .01).


CONCLUSIONS
Although histologic and additional regenerative changes are seen, HVE in addition to PVE has no additional short-term effect on hypertrophy response. The combination of HVE and PVE may therefore have little use in a clinical setting.
Department of Interventional Radiology, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. k.p.vanlienden@amc.uva.nl
Krijn P
KP
van Lienden
Jacomina W
JW
van den Esschert
Max
M
Rietkerk
Michal
M
Heger
Joris J T H
JJ
Roelofs
Johan S
JS
Lameris
Thomas M
TM
van Gulik
D000818:Animals; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006503:Hepatic Veins / Q000000981:diagnostic imaging / Q000502:physiology*; D008099:Liver / Q000000981:diagnostic imaging / Q000254:growth & development*; D008115:Liver Regeneration / Q000502:physiology*; D011169:Portal Vein / Q000000981:diagnostic imaging / Q000502:physiology*; D011817:Rabbits; D011859:Radiography; D016896:Treatment Outcome