ABSTRACT
Objective In order to investigate the therapeutic effects of portal arterialization for portal hypertension,portal arterialization and complete shunt(PACS) was applied in canine model of portal hypertension,which was made by thread embolization within the portal vein.Methods A splenectomy,splenic artery and upper portal vein anastomosis,and a complete portal-caval shunt were performed on portal hypertension dogs.The blood pressure and flow of the portal vein including that towards the liver and towards the vena cava were observed.Results The postoperative hepatic inflow,PVF,increased to 180% of the former while PVP increased to 196%;the caval-inflow PVF increased to 130% of the former while PVP decreased to 45.5%.Significant difference existed(P
ABSTRACT
Objective To study the effect on liver hemodynamics of portal arterialization and complete shunt(PACS),splenorenal shut(SRS) and peripheral cardia divided vessel(PCDV).Methods The preparation of canine model was made.Group PCDV accepted a splenectomy and peripheral cardia divided vessel,while the group SRS accepted a spleen-renal vein shunt.Group PACS accepted a splenectomy,splenic artery and upper portal vein anastomosis,and complete portal-caval shunt.The blood pressure and flow of the portal system were observed.The hepatic function was also measured before and 2 weeks after the three kinds of operation.Results In the PCDV group,the postoperative PVF decreased in 17% while PVP decreased in 5%.In the SRS group,the postoperative PVF decreased in 51% while PVP decreased in 51%.In the PACS group,the postoperative hepatic inflow PVF increased to 180% of the former while PVP increased to 196%;the caval-inflow PVF increased to 130% of the former while PVP decreased to 46%.The results of PACS group had a magnificent statistic difference comparing with those two traditional operations(P
ABSTRACT
PURPOSE: In liver transplantation, low portal perfusion pressure may result in underperfusion of grafts and be the cause of primary nonfunction. Partial arterialization of portal vein could preserve graft perfusion. Up till now, there have been several clinical cases of temporary or permanent portal arterialization in liver transplantation. METHODS: In this study, we designed rat model for evaluating the effect of portal arterialization to improve survival of the under-perfused graft. Partial heterotopic non-regenerative liver transplantation was used with portal inflow only from inferior vena cava, which is known as portal under-perfusing liver transplantation model. Partial portal arterialization was performed by fenestration of the common wall between the IVC and the aorta through venotomy which was made for portacaval anastomosis. RESULTS: Immediate after arterialization, satisfactory macroscopic and duplex ultrasonographic liver perfusion were seen and the arterialized-graft survival was significantly improved to 95% (19/20) vs. 35% (7/20) of nonarterialized grafts. At 2-week after transplantation, the arterialized liver graft was atrophied showed normal gross appearance. The histopathologic examination with light microscope revealed no significant pathologic abnormality. CONCLUSION: Partial portal arteria;ization improved graft-survival of the under-perfusing liver grafts significantly and not affects the histologic hepatic structure adversely.