Improved hepatocyte function of future liver remnant of cirrhotic rats after portal vein ligation: A bonus other than volume shifting

BackgroundPreoperative portal vein embolization is increasingly employed for those with hepatocellular carcinoma and cirrhosis to gain a volume-shifting effect. However, the alterations of histologic architecture and hepatocyte function of future liver remnant (FLR) remain unexplored.MethodsPortal vein ligation (PVL) was performed in cirrhotic and noncirrhotic rats. Regeneration indices that include the DNA synthesis index, restituted liver mass, and the redistributed volume ratio were measured. The indocyanine green 15′ retention test (ICG-R15), histologic changes, total Knodell score, and activated hepatic stellate cells (HSCs) were measured before and after PVL. Tc-99m sulfur-colloid liver single photon emission computed tomography (SPECT) and diisopropyl iminoacetic acid (DISIDA) SPECT were conducted.ResultsThe redistributed volume ratio of cirrhotic rats was less than noncirrhotic rats (63% vs 80%, P < .01). The ICG-R15 of cirrhotic rats at day 7 after PVL was improved compared with baseline (6.0 ± 4.1% vs 15.8 ± 4.6%, P < .01). The total Knodell score and activated HSCs of FLR in cirrhotic rats both were decreased compared with those of baseline. The redistributed volume ratio of noncirrhotic and cirrhotic rats based on 99mTc sulfur-colloid SPECT were 79% and 64%, respectively. The clearance T1/2 of FLR in cirrhotic rats based on DISIDA SPECT was decreased compared with baseline (5.2 ± 1.9 min vs 8.6 ± 3.1 min).ConclusionThe regenerated functional liver mass of cirrhotic rats after PVL is less than noncirrhotic rats, whereas the hepatocyte function of FLR in cirrhotic rats is improved relevant to tissue remodeling.