Hyperperfusion Syndrome in Small-for-Size Livers
- 1 December 2005
- journal article
- Published by S. Karger AG in European Surgical Research
- Vol. 37 (6), 335-341
- https://doi.org/10.1159/000090333
Abstract
Portal hyperperfusion in small-for-size livers might seriously impair postoperative liver regeneration. Using an experimental model, we investigated splenectomy as a measure to reduce portal blood flow and its impact on postoperative recovery following extended liver resection. Wistar rats underwent partial (90%) hepatectomy with or without splenectomy under temporary inflow occlusion (30 min). In addition to 10-day survival rate, laser Doppler flowmetry of hepatic blood flow and fluorescence microscopic analysis of hepatic microcirculation were performed to assess the effect of splenectomy on initial microvascular reperfusion of liver remnants. While postischemic perfusion failure was comparable between both groups, portal blood flow was significantly reduced after simultaneous splenectomy (3.5+/-0.4 vs. 5.4+/-0.4 ml/min). Moreover, red blood cell velocity and volumetric blood flow were reduced in splenectomized animals. These animals experienced lower AST levels (421+/-36 vs. 574+/-73 U/l) and a significantly increased survival rate, reaching 6.6+/-1.3 vs 2.6+/-0.8 days. Simultaneous splenectomy significantly reduced the risk for postoperative hyperperfusion syndrome in small-for-size livers. Shear-stress-induced liver injury was diminished due to a significant reduction of portal venous blood flow, which positively influenced postoperative regeneration resulting in significantly higher survival.Keywords
This publication has 19 references indexed in Scilit:
- Small-for-size graft in living donor liver transplantation: How far should we go?Liver Transplantation, 2003
- Clinical relevance of adapting portal vein flow in living donor liver transplantation in adult patientsLiver Transplantation, 2003
- Small-for-size liver syndrome after auxiliary and split liver transplantation: Donor selectionLiver Transplantation, 2003
- Small-for-size syndrome: What is the problem?Liver Transplantation, 2003
- Portal hyperperfusion injury as the cause of primary nonfunction in a small-for-size liver graft-successful treatment with splenic artery ligationLiver Transplantation, 2003
- Changes in portal vein flow after adult living-donor liver transplantation: Does it influence postoperative liver function?Liver Transplantation, 2003
- Relationship between portal venous flow and liver regeneration in patients after living donor right-lobe liver transplantationLiver Transplantation, 2003
- Changes in portal venous pressure in the early phase after living donor liver transplantation: pathogenesis and clinical implications1,2Transplantation, 2003
- Hepatic arteriolo‐portal venular shunting guarantees maintenance of nutritional microvascular supply in hepatic arterial buffer response of rat liversThe Journal of Physiology, 2001
- The microcirculatory hepatic unitMicrovascular Research, 1973