title: Development of a standardized model for liver failure in pigs: anatomopathophysiologic findings after extended liver resection.
abstract: Eighteen pigs weighing a mean 19 ± 4 kg, were divided into group 1 (n = 2), that underwent resection of the left lateral lobe, group 2 (n = 2), resection of the left median and right median lobes; and group 3 (n = 18), resection of the left lateral, left median, right median, and right lateral lobes. All animals were followed for 5 days. Liver failure (n = 8) leading to animal death within 3 days after surgery was observed in 65% of group 3, whereas no group 1 or 2 animal experienced liver insufficiency. Multivariate analysis revealed that the extent of liver resection expressed as a percentage of total body weight <2.3%, international normalized ratio > 1.6 as postoperative day 2, serum bilirubin > 4.2 on postoperative day 2, and serum lactates > 9 mmol/L after resection were independent predictors of liver failure (P < .05). The number of resected liver lobes was not a good predictor of liver failure in swine, whereas the extent of resection expressed as a percentage of total body weight was an independent predictor of early liver failure. A resected liver-to-body weight ratio >2.3% was associated with a 65% probability of developing liver insufficiency. This parameter may be useful when developing a model of liver failure after extended liver resection in swine.
authors.affiliation: Department of Abdominal and Transplantation Surgery, Mediterranean Institute for Transplantation and Advanced Specialized Therapies, University of Pittsburgh Medical Center in Italy, Palermo, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Pagano
authors.forename: F
authors.initials: F
authors.lastname: di Francesco
authors.forename: G J
authors.initials: GJ
authors.lastname: Echeverri
authors.forename: M
authors.initials: M
authors.lastname: de Martino
authors.forename: C
authors.initials: C
authors.lastname: Ricotta
authors.forename: G
authors.initials: G
authors.lastname: Occhipinti
authors.forename: V
authors.initials: V
authors.lastname: Pagano
authors.forename: E
authors.initials: E
authors.lastname: Oliva
authors.forename: M I
authors.initials: MI
authors.lastname: Minervini
authors.forename: B G
authors.initials: BG
authors.lastname: Gridelli
authors.forename: M
authors.initials: M
authors.lastname: Spada
mesh_terms: D000818:Animals; D001663:Bilirubin / Q000097:blood; D004195:Disease Models, Animal; D019934:International Normalized Ratio; D007773:Lactates / Q000097:blood; D017093:Liver Failure / Q000503:physiopathology* / Q000601:surgery; D015996:Survival Rate; D013552:Swine
chemical_list: D007773:Lactates; D001663:Bilirubin