title: Bioartificial liver attenuates intestinal mucosa injury and gut barrier dysfunction after major hepatectomy: Study in a porcine model.
abstract: The aim of this study was to evaluate whether bioartificial liver support can attenuate gut mucosa injury in a porcine model of posthepatectomy liver dysfunction.
  
  
  
  Posthepatectomy liver failure was induced in pigs combining major (70%) liver resection and ischemia/reperfusion injury. An ischemic period of 150 minutes was followed by reperfusion for 24 hours. Animals were divided randomly into 2 groups: a control group (n = 6) that received standard critical care and a bioartificial liver support group (Hepat, n = 6) that were subjected to extracorporeal liver support for 6 hours during reperfusion. Intestinal mucosal injury, bacterial translocation, and endotoxin translocation were evaluated in all animals. Intestinal mucosa was also evaluated with markers of oxidative injury and immunohistochemical staining for caspase 3.
  
  
  
  When compared with median values, the control group, animals in the Hepat group had a lesser intestinal mucosal injury score (4.0 [range:2.0-5.0] vs 1.0 [range:1.0-2.0]; P < .01), decreased bacterial translocation in the portal and the systemic circulation at 24 hours of reperfusion (P < .05), and decreased portal and systemic endotoxin levels at 24 hours (P < .05). At 24 hours after reperfusion, mucosal protein carbonyls and malondialdehyde levels were decreased in Hepat animals (0.57 nmol/mg [range:0.32-0.70] vs 0.33 nmol/mg [range:0.03-0.53] and 3.85 nmol/mg [range:3.01-6.43] vs 3.27 nmol/mg [range:1.46-3.55], respectively; P < .05). There was no difference in tissue caspase staining.
  
  
  
  Bioartificial liver support seems to attenuate intestinal mucosal injury and gut barrier dysfunction after major hepatectomy.
authors: Second Department of Surgery, School of Medicine, National and Kapodistrian University of Athens, Aretaieion University Hospital, Athens, Greece. Electronic address: kosnastos@yahoo.gr.
authors: Constantinos
authors: C
authors: Nastos
authors: Second Department of Anesthesiology, School of Medicine, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece.
authors: Konstantinos
authors: K
authors: Kalimeris
authors: Second Department of Anesthesiology, School of Medicine, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece.
authors: Nikolaos
authors: N
authors: Papoutsidakis
authors: Second Department of Surgery, School of Medicine, National and Kapodistrian University of Athens, Aretaieion University Hospital, Athens, Greece.
authors: George
authors: G
authors: Defterevos
authors: Department of Pathology, School of Medicine, National and Kapodistrian University of Athens, Aretaieion University Hospital, Athens, Greece.
authors: Agathi
authors: A
authors: Pafiti
authors: Laboratory of Biopathology, Attikon University Hospital, Athens, Greece.
authors: Eleni
authors: E
authors: Kalogeropoulou
authors: Laboratory of Biopathology, Attikon University Hospital, Athens, Greece.
authors: Loukia
authors: L
authors: Zerva
authors: Department of the Science Nutrition - Dietetics, Harokopio University, Athens, Greece.
authors: Tzortzis
authors: T
authors: Nomikos
authors: Experimental Research Department of ELPEN-Pharma, Athens, Greece.
authors: Apostolos
authors: A
authors: Papalois
authors: Second Department of Anesthesiology, School of Medicine, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece.
authors: Georgia
authors: G
authors: Kostopanagiotou
authors: Fourth Department of Surgery, School of Medicine, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece.
authors: Vasillios
authors: V
authors: Smyrniotis
authors: Fourth Department of Surgery, School of Medicine, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece.
authors: Nikolaos
authors: N
authors: Arkadopoulos
mesh_terms: D000818:Animals; D018988:Bacterial Translocation; D004195:Disease Models, Animal; D004731:Endotoxins; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects*; D007413:Intestinal Mucosa / Q000293:injuries*; D017093:Liver Failure / Q000209:etiology / Q000628:therapy*; D019164:Liver, Artificial; D018384:Oxidative Stress; D015427:Reperfusion Injury / Q000209:etiology*; D013552:Swine
chemical_list: D004731:Endotoxins