Does Arterialization of Portal Vein Have Any Effects in Large-for-Size Liver Transplantation? Hemodynamic, Histological, and Biomolecular Experimental Studies

Imagem de Miniatura
Arquivos
art_TORRES_Does_Arterialization_of_Portal_Vein_Have_Any_Effects_2022.PDF (1.73 MB)
Citações na Scopus
0
Tipo de produção
article
Data de publicação
2022
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
TAYLOR & FRANCIS INC
Autores
Citação
JOURNAL OF INVESTIGATIVE SURGERY, v.35, n.6, p.1197-1207, 2022
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
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.
Palavras-chave
Large-for-size liver transplantation, complications of liver transplantation, liver transplantation, pediatric liver transplantation, animal model
URI
https://observatorio.fm.usp.br/handle/OPI/47205
Referências
  1. Tannuri ACA, 2017, PEDIATR TRANSPLANT, V21, DOI 10.1111/petr.12928
  2. Tannuri ACA, 2016, CLINICS, V71, P185, DOI 10.6061/clinics/2016(04)01
  3. Basso Celeste Del, 2021, Ann Hepatobiliary Pancreat Surg, V25, P426, DOI 10.14701/ahbps.2021.25.3.426
  4. Belon AR, 2022, J INVEST SURG, V35, P900, DOI 10.1080/08941939.2021.1933274
  5. Bhangui P, 2014, HPB, V16, P723, DOI 10.1111/hpb.12200
  6. Datta G, 2013, WORLD J GASTROENTERO, V19, P1683, DOI 10.3748/wjg.v19.i11.1683
  7. de Pinho-Apezzato ML, 2011, PEDIATR TRANSPLANT, V15, P617, DOI 10.1111/j.1399-3046.2011.01538.x
  8. FARHOOD A, 1995, J LEUKOCYTE BIOL, V57, P368, DOI 10.1002/jlb.57.3.368
  9. Leal AJG, 2015, CLINICS, V70, P126, DOI 10.6061/clinics/2015(02)10
  10. Leal AJG, 2013, CLINICS, V68, P1152, DOI 10.6061/clinics/2013(08)15
  11. Guan LY, 2014, WORLD J GASTRO SURG, V6, P122, DOI 10.4240/wjgs.v6.i7.122
  12. Kasahara M, 2021, TRANSPLANTATION, V105, P2587, DOI 10.1097/TP.0000000000003610
  13. Klune JR, 2010, SURG CLIN N AM, V90, P665, DOI 10.1016/j.suc.2010.04.003
  14. Kobayashi E, 2012, TRANSPLANT RES, V1, DOI 10.1186/2047-1440-1-8
  15. Majlesara A, 2021, CAN J SURG, V64, pE173, DOI 10.1503/cjs.012419
  16. Matsushima H, 2020, TRANSPLANTATION, V104, P770, DOI 10.1097/TP.0000000000002968
  17. Nardo B, 2006, TRANSPLANT P, V38, P1195, DOI 10.1016/j.transproceed.2006.04.002
  18. Ogata A, 1997, J GASTROEN HEPATOL, V12, P633, DOI 10.1111/j.1440-1746.1997.tb00526.x
  19. Pulitano C, 2017, LIVER TRANSPLANT, V23, P527, DOI 10.1002/lt.24721
  20. Moreira DDAR, 2014, J SURG RES, V189, P313, DOI 10.1016/j.jss.2014.03.018
  21. Shimizu Y, 2000, BRIT J SURG, V87, P784, DOI 10.1046/j.1365-2168.2000.01382.x
  22. Tannuri U, 2008, PEDIATR TRANSPLANT, V12, P73, DOI 10.1111/j.1399-3046.2007.00801.x
  23. Tannuri U, 2014, CLINICS, V69, P42, DOI 10.6061/clinics/2014(Sup01)08
  24. Uhlmann D, 2000, J CARDIOVASC PHARM, V36, pS212, DOI 10.1097/00005344-200036001-00064
  25. Zakaria HM, 2021, PEDIATR TRANSPLANT, V25, DOI 10.1111/petr.14044
  26. Zhang K, 2014, WORLD J GASTROENTERO, V20, P12359, DOI 10.3748/wjg.v20.i34.12359

Coleções
Artigos e Materiais de Revistas Científicas - FM/MPE
Artigos e Materiais de Revistas Científicas - HC/ICr
Artigos e Materiais de Revistas Científicas - LIM/26
Artigos e Materiais de Revistas Científicas - LIM/30