title: Subtotal hepatectomy in swine for studying small-for-size syndrome and portal inflow modulation: is it reliable?
abstract: BACKGROUND
  Small-for-size syndrome (SFSS) is a feared complication of extended liver resection and partial liver transplantation. Swine models of extended hepatectomy have been developed for studying SFSS and its different treatment options. Although portal inflow modulation (PIM) by splenectomy or splenic artery ligation (SAL) has been proposed in humans to prevent SFSS, such procedures have not yet been evaluated in swine.
  
  
  OBJECTIVE
  The present study was designed to evaluate modifications in splanchnic haemodynamics yielded by extended hepatectomy with and without PIM in swine.
  
  
  METHODS
  Nineteen animals underwent 70% hepatectomy (H70, n = 7), 90% hepatectomy (H90, n = 7) or sham laparotomy (H0, n = 5). Haemodynamic measurements were performed at baseline, after hepatectomy and after PIM by SAL and splenectomy.
  
  
  RESULTS
  Portal vein flow increased after both H70 (273 ml/min/100 g versus 123 ml/min/100 g; P = 0.016) and H90 (543 ml/min/100 g versus 124 ml/min/100 g; P = 0.031), but the hepatic venous pressure gradient (HVPG) increased only after H90 (10.0 mmHg versus 3.7 mmHg; P = 0.016). Hepatic artery flow did not significantly decrease after either H70 or H90. In all three groups, neither splenectomy nor SAL induced any changes in splanchnic haemodynamics.
  
  
  CONCLUSIONS
  Subtotal hepatectomy of 90% in swine is a reliable model for SFSS inducing a significant increase in HVPG. However, in view of the relevant differences between swine and human splanchnic anatomy, this model is inadequate for studying the effects of PIM by SAL and splenectomy.
authors.affiliation: Department of General Surgery and Liver Transplantation, Croix-Rousse University Hospital, Hospices Civils de Lyon, Lyon, France.|Equipe mixte de Recherche 37-38, Ecole Doctorale EDISS 205, Claude Bernard University Lyon 1, Lyon, France.
authors.forename: Benjamin
authors.identifier: http://orcid.org/0000-0003-1084-6096
authors.initials: B
authors.lastname: Darnis
authors.affiliation: Department of General Surgery and Liver Transplantation, Croix-Rousse University Hospital, Hospices Civils de Lyon, Lyon, France.|Equipe mixte de Recherche 37-38, Ecole Doctorale EDISS 205, Claude Bernard University Lyon 1, Lyon, France.
authors.forename: Kayvan
authors.initials: K
authors.lastname: Mohkam
authors.affiliation: Department of Intensive Care and Anesthesiology, Croix-Rousse University Hospital, Hospices Civils de Lyon, Lyon, France.
authors.forename: Zoé
authors.initials: Z
authors.lastname: Schmitt
authors.affiliation: Department of Intensive Care, Lyon-Sud University Hospital, Hospices Civils de Lyon, Pierre-Bénite, France.
authors.forename: Stanislas
authors.initials: S
authors.lastname: Ledochowski
authors.affiliation: Department of Intensive Care and Anesthesiology, Croix-Rousse University Hospital, Hospices Civils de Lyon, Lyon, France.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Vial
authors.affiliation: Department of Intensive Care and Anesthesiology, Croix-Rousse University Hospital, Hospices Civils de Lyon, Lyon, France.
authors.forename: Serge
authors.initials: S
authors.lastname: Duperret
authors.affiliation: Surgery School Laboratory, Claude Bernard University Lyon 1, Lyon, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Vogt
authors.affiliation: Department of General Surgery and Liver Transplantation, Croix-Rousse University Hospital, Hospices Civils de Lyon, Lyon, France.
authors.forename: Hassan
authors.initials: H
authors.lastname: Demian
authors.affiliation: Department of General Surgery and Liver Transplantation, Croix-Rousse University Hospital, Hospices Civils de Lyon, Lyon, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Golse
authors.affiliation: Department of General Surgery and Liver Transplantation, Croix-Rousse University Hospital, Hospices Civils de Lyon, Lyon, France.
authors.forename: Salim
authors.initials: S
authors.lastname: Mezoughi
authors.affiliation: Department of General Surgery and Liver Transplantation, Croix-Rousse University Hospital, Hospices Civils de Lyon, Lyon, France.
authors.forename: Christian
authors.initials: C
authors.lastname: Ducerf
authors.affiliation: Department of General Surgery and Liver Transplantation, Croix-Rousse University Hospital, Hospices Civils de Lyon, Lyon, France.|Equipe mixte de Recherche 37-38, Ecole Doctorale EDISS 205, Claude Bernard University Lyon 1, Lyon, France.
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Mabrut
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D008099:Liver / Q000098:blood supply* / Q000601:surgery; D008102:Liver Circulation / Q000502:physiology*; D009929:Organ Size; D017082:Portal Pressure / Q000502:physiology*; D011169:Portal Vein / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications / Q000503:physiopathology*; D012039:Regional Blood Flow / Q000502:physiology*; D013157:Splenic Artery / Q000601:surgery; D013552:Swine; D013577:Syndrome