title: Hemodynamics in rat liver tumor model during retrograde-outflow isolated hepatic perfusion with aspiration from the portal vein: angiography and in vivo microscopy.
abstract: BACKGROUND
  Orthograde percutaneous isolated hepatic perfusion (IHP) techniques using balloon occlusion catheters are relatively simple and facilitate repeated therapy, but they result in higher rates of leakage from the perfusion circuit into the systemic circulation. Therefore, a feasible protocol for percutaneous IHP with less leakage is required.
  
  
  OBJECTIVE
  To investigate hemodynamic changes in rat liver and tumor during retrograde-outflow isolated hepatic perfusion (R-IHP) with aspiration from the portal vein (PV).
  
  
  METHODS
  Animal experiments were approved by the Animal Experiment Ethics Committee of Lund University. Eighteen rats underwent R-IHP after laparotomy and catheterization of the PV and hepatic artery (HA). The HA, inferior vena cava (IVC), and PV were ligated, and flow through the suprahepatic IVC was controlled with a suture loop. The rats were divided into two groups to examine blood flow during R-IHP. Four rats (group 1) underwent arteriography via the HA with and without R-IHP, and 14 rats (group 2) were inoculated with tumor and examined by in vivo fluorescence microscopy of liver and tumor during R-IHP.
  
  
  RESULTS
  In group 1, hepatic arteriography during R-IHP confirmed arterioportal communication in all four rats, with the PV acting as an outflow tract. In vivo fluorescence microscopy in group 2 showed strong enhancement of tumors, and no blood supply from the portal venules to the tumors was seen in any of the 14 rats. Blood flow in the major portion of the hepatic lobules was stopped and the percentage of enhanced area was significantly lower in the normal hepatic lobules than in the tumors (P < 0.0001).
  
  
  CONCLUSIONS
  We confirmed reversal of blood flow concomitant with good perfusion of the liver tumor and with reduced perfusion of normal liver parenchyma during R-IHP.
authors.affiliation: Department of Radiology, Nippon Medical School, Tokyo, Japan genji@nms.ac.jp.
authors.forename: Satoru
authors.initials: S
authors.lastname: Murata
authors.affiliation: Department of General Surgery, Lund University and Skåne University Hospital, Malmoe, Sweden.
authors.forename: Bengt
authors.initials: B
authors.lastname: Jeppsson
authors.affiliation: Department of Radiology, Lund University and Skåne University Hospital, Malmoe, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Lunderquist
authors.affiliation: Department of Radiology, University College of London Hospital, London, UK.
authors.forename: Krassi
authors.initials: K
authors.lastname: Ivancev
mesh_terms: D015901:Angiography, Digital Subtraction / Q000379:methods; D000818:Animals; D004195:Disease Models, Animal; D006439:Hemodynamics; D006499:Hepatic Artery / Q000000981:diagnostic imaging*; D008026:Ligation; D008099:Liver / Q000098:blood supply / Q000000981:diagnostic imaging; D008102:Liver Circulation / Q000502:physiology; D008114:Liver Neoplasms, Experimental / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000473:pathology*; D008833:Microcirculation / Q000502:physiology; D008856:Microscopy, Fluorescence / Q000379:methods; D011169:Portal Vein / Q000000981:diagnostic imaging*; D051381:Rats; D017208:Rats, Wistar; D013396:Suction / Q000379:methods
keywords: Interventional; animal investigations; experimental investigations; liver