Early effects of portal flow modulation after extended liver resection in rat

IntroductionThe incidence of small-for-size-liver-syndrome after liver transplantation and extended liver resection may be reduced by portal flow modulation. However, many aspects of the small-for-size-liver-syndrome pathogenesis are still unclear. In this experimental study we evaluated the early effects of portal flow modulation after 80% hepatic resection in rats.Materials and methodsRats were randomised in: sham operation (G1), conventional hepatic resection (G2), splenectomy and hepatic resection (G3), splenic transposition followed by hepatic resection after three weeks (G4). Six hours after operation, oxygen saturation of hepatic vein blood, glutathione, and standard liver markers were measured from hepatic venous blood. Glutathione measurement and histopatological examination were performed in the remnant liver.ResultsTotal bilirubin and liver glutathione did not show differences between groups. Aspartate aminotransferase and alanine aminotransferase significantly increased in G2–G4 groups. Blood glutathione and oxygen saturation of hepatic vein blood were lower in G2 than in other groups. A gradient of micro-vesicular degeneration was more severe in G2 compared with G3 and G4. Apoptosis, hemorrhagic necrosis, mitochondrial damage and leucocyte adhesion were evident in G2.ConclusionThe portal flow modulation induced by splenectomy or splenic transposition was effective in limiting early damage after extended liver resection.

► Portal overflow plays a major role in liver dysfunction after hepatic resection.
► Endothelial activation and hepatocyte vacuolisation occur quickly after resection.
► Early mitochondrial injury leads to alterations in oxygen and glutathione metabolism.
► Splenectomy and porto-caval shunts reduce the portal flow after hepatic resection.
► Reduction of portal flow decreases the hepatic injuries and mitochondria alterations.