Rafael Rodrigues Torres, Ana Cristina Aoun Tannuri, Suellen Serafini, Alessandro Belon, Josiane Oliveira Gonçalves, Celso di Loreto, Uenis Tannuri
{"title":"门静脉动脉化对大尺寸肝移植有影响吗?血液动力学、组织学和生物分子实验研究。","authors":"Rafael Rodrigues Torres, Ana Cristina Aoun Tannuri, Suellen Serafini, Alessandro Belon, Josiane Oliveira Gonçalves, Celso di Loreto, Uenis Tannuri","doi":"10.1080/08941939.2021.2021333","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>In pediatric liver transplantation, the optimal size of the transplanted liver ranges between 0.8% and 4.0% of the recipient's weight. Sometimes, the graft weight exceeds this upper limit, characterizing the large-for-size condition potentially associated with reduced blood flow and worsening of ischemia-reperfusion injury. Therefore, it would be beneficial to increase the portal flow through arterialization of the portal vein. <b>Materials and methods:</b> Fifteen pigs underwent large-for-size liver transplants. They were divided into two groups: control (CTRL 6 animals - conventional technique) and arterialization - a shunt was established between the portal vein and the splenic artery (ART 9 animals). Hemodynamic, biochemical, histological, and molecular variables were compared. <b>Results</b>: Arterialization resulted in a significant increase in portal vein pressure but no changes in other hemodynamic variables, as shown in the analysis of variance. It was observed lower ALT values (<i>p</i> = 0.007), with no differences regarding the values of blood pH and lactate (<i>p</i> = 0.54 and <i>p</i> = 0.699 respectively) or histological variables (edema, steatosis, inflammation, necrosis, and IRI - <i>p</i> = 1.0, <i>p</i> = 0.943, <i>p</i> = 0.174, <i>p</i> = 0.832, <i>p</i> = 0.662, respectively). The molecular studies showed significantly increased expression of IL6 after 3 hours of reperfusion (<i>p</i> = 0.048) and decreased expression of ICAM immediately after reperfusion (<i>p</i> = 0.03). The regression analysis suggested a positive influence of portal flow and pressure on biochemical parameters. <b>Conclusion</b>: Arterialization of the portal vein showed no histological, biochemical, or molecular benefits in large-for-size transplantation.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 6","pages":"1197-1207"},"PeriodicalIF":2.1000,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Does Arterialization of Portal Vein Have Any Effects in Large-for-Size Liver Transplantation? Hemodynamic, Histological, and Biomolecular Experimental Studies.\",\"authors\":\"Rafael Rodrigues Torres, Ana Cristina Aoun Tannuri, Suellen Serafini, Alessandro Belon, Josiane Oliveira Gonçalves, Celso di Loreto, Uenis Tannuri\",\"doi\":\"10.1080/08941939.2021.2021333\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>In pediatric liver transplantation, the optimal size of the transplanted liver ranges between 0.8% and 4.0% of the recipient's weight. Sometimes, the graft weight exceeds this upper limit, characterizing the large-for-size condition potentially associated with reduced blood flow and worsening of ischemia-reperfusion injury. Therefore, it would be beneficial to increase the portal flow through arterialization of the portal vein. <b>Materials and methods:</b> Fifteen pigs underwent large-for-size liver transplants. They were divided into two groups: control (CTRL 6 animals - conventional technique) and arterialization - a shunt was established between the portal vein and the splenic artery (ART 9 animals). Hemodynamic, biochemical, histological, and molecular variables were compared. <b>Results</b>: Arterialization resulted in a significant increase in portal vein pressure but no changes in other hemodynamic variables, as shown in the analysis of variance. It was observed lower ALT values (<i>p</i> = 0.007), with no differences regarding the values of blood pH and lactate (<i>p</i> = 0.54 and <i>p</i> = 0.699 respectively) or histological variables (edema, steatosis, inflammation, necrosis, and IRI - <i>p</i> = 1.0, <i>p</i> = 0.943, <i>p</i> = 0.174, <i>p</i> = 0.832, <i>p</i> = 0.662, respectively). The molecular studies showed significantly increased expression of IL6 after 3 hours of reperfusion (<i>p</i> = 0.048) and decreased expression of ICAM immediately after reperfusion (<i>p</i> = 0.03). The regression analysis suggested a positive influence of portal flow and pressure on biochemical parameters. <b>Conclusion</b>: Arterialization of the portal vein showed no histological, biochemical, or molecular benefits in large-for-size transplantation.</p>\",\"PeriodicalId\":16200,\"journal\":{\"name\":\"Journal of Investigative Surgery\",\"volume\":\"35 6\",\"pages\":\"1197-1207\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2022-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Investigative Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/08941939.2021.2021333\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2021/12/29 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Investigative Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/08941939.2021.2021333","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2021/12/29 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
Does Arterialization of Portal Vein Have Any Effects in Large-for-Size Liver Transplantation? Hemodynamic, Histological, and Biomolecular Experimental Studies.
Background: In pediatric liver transplantation, the optimal size of the transplanted liver ranges between 0.8% and 4.0% of the recipient's weight. Sometimes, the graft weight exceeds this upper limit, characterizing the large-for-size condition potentially associated with reduced blood flow and worsening of ischemia-reperfusion injury. Therefore, it would be beneficial to increase the portal flow through arterialization of the portal vein. Materials and methods: Fifteen pigs underwent large-for-size liver transplants. They were divided into two groups: control (CTRL 6 animals - conventional technique) and arterialization - a shunt was established between the portal vein and the splenic artery (ART 9 animals). Hemodynamic, biochemical, histological, and molecular variables were compared. Results: Arterialization resulted in a significant increase in portal vein pressure but no changes in other hemodynamic variables, as shown in the analysis of variance. It was observed lower ALT values (p = 0.007), with no differences regarding the values of blood pH and lactate (p = 0.54 and p = 0.699 respectively) or histological variables (edema, steatosis, inflammation, necrosis, and IRI - p = 1.0, p = 0.943, p = 0.174, p = 0.832, p = 0.662, respectively). The molecular studies showed significantly increased expression of IL6 after 3 hours of reperfusion (p = 0.048) and decreased expression of ICAM immediately after reperfusion (p = 0.03). The regression analysis suggested a positive influence of portal flow and pressure on biochemical parameters. Conclusion: Arterialization of the portal vein showed no histological, biochemical, or molecular benefits in large-for-size transplantation.
期刊介绍:
Journal of Investigative Surgery publishes peer-reviewed scientific articles for the advancement of surgery, to the ultimate benefit of patient care and rehabilitation. It is the only journal that encompasses the individual and collaborative efforts of scientists in human and veterinary medicine, dentistry, basic and applied sciences, engineering, and law and ethics. The journal is dedicated to the publication of outstanding articles of interest to the surgical research community.