title: Preserving low perfusion during surgical liver blood inflow control prevents hepatic microcirculatory dysfunction and irreversible hepatocyte injury in rats.
abstract: Hepatic ischaemia/reperfusion (I/R) injury is of primary concern during liver surgery. We propose a new approach for preserving low liver blood perfusion during hepatectomy either by occlusion of the portal vein (OPV) while preserving hepatic artery flow or occlusion of the hepatic artery while limiting portal vein (LPV) flow to reduce I/R injury. The effects of this approach on liver I/R injury were investigated. Rats were randomly assigned into 4 groups: sham operation, occlusion of the portal triad (OPT), OPV and LPV. The 7-day survival rate was significantly improved in the OPV and LPV groups compared with the OPT group. Microcirculatory liver blood flow recovered rapidly after reperfusion in the OPV and LPV groups but decreased further in the OPT group. The OPV and LPV groups also showed much lower ALT and AST levels, Suzuki scores, inflammatory gene expression levels, and parenchymal necrosis compared with the OPT group. An imbalance between the expression of vasoconstriction and vasodilation genes was observed in the OPT group but not in the OPV or LPV group. Therefore, preserving low liver blood perfusion by either the OPV or LPV methods during liver surgery is very effective for preventing hepatic microcirculatory dysfunction and hepatocyte injury.
authors.affiliation: Department and Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Chinese PLA Medical School, Beijing, China.
authors.forename: Chong-Hui
authors.initials: CH
authors.lastname: Li
authors.affiliation: Department and Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Chinese PLA Medical School, Beijing, China.
authors.forename: Yong-Wei
authors.initials: YW
authors.lastname: Chen
authors.affiliation: Department and Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Chinese PLA Medical School, Beijing, China.
authors.forename: Yong-Liang
authors.initials: YL
authors.lastname: Chen
authors.affiliation: Department and Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Chinese PLA Medical School, Beijing, China.
authors.forename: Li-Bin
authors.initials: LB
authors.lastname: Yao
authors.affiliation: Department and Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Chinese PLA Medical School, Beijing, China.
authors.forename: Xin-Lan
authors.initials: XL
authors.lastname: Ge
authors.affiliation: Department and Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Chinese PLA Medical School, Beijing, China.
authors.forename: Ke
authors.initials: K
authors.lastname: Pan
authors.affiliation: Department and Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Chinese PLA Medical School, Beijing, China.
authors.forename: Ai-Qun
authors.initials: AQ
authors.lastname: Zhang
authors.affiliation: Department and Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Chinese PLA Medical School, Beijing, China.
authors.forename: Jia-Hong
authors.initials: JH
authors.lastname: Dong
mesh_terms: D000818:Animals; D016207:Cytokines / Q000097:blood / Q000378:metabolism; D003952:Diagnostic Imaging / Q000379:methods; D004195:Disease Models, Animal; D042783:Endothelial Cells / Q000378:metabolism; D015870:Gene Expression; D006498:Hepatectomy / Q000379:methods; D006499:Hepatic Artery; D022781:Hepatocytes; D018836:Inflammation Mediators / Q000378:metabolism; D008099:Liver / Q000098:blood supply* / Q000473:pathology / Q000601:surgery*; D008107:Liver Diseases / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology / Q000517:prevention & control*; D008111:Liver Function Tests; D008297:Male; D008833:Microcirculation; D011169:Portal Vein; D051381:Rats; D012038:Regeneration; D012039:Regional Blood Flow; D015427:Reperfusion Injury / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology / Q000517:prevention & control*; D060205:Therapeutic Occlusion / Q000379:methods; D013997:Time Factors
chemical_list: D016207:Cytokines; D018836:Inflammation Mediators