Protective effects of affiliating portasystemic shunt on graft injury in small-for-size liver transplantation in miniature pigs / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVES</b>To evaluate the protective effects of affiliating portasystemic shunt on small-for-size graft in liver transplantation.</p><p><b>METHODS</b>Fifteen Chinese Bama miniature pigs were divided into three groups group A (small-for-size liver transplantation), group B (distal splenorenal shunt + small-for-size liver transplantation), and group C (mesocaval H-shape shunt + small-for-size liver transplantation). Animals were followed up for 7 days with survival, dynamical liver function biochemical parameters, liver biopsies, portal venous pressure (PVP) and portal blood flow (PBF).</p><p><b>RESULTS</b>Animal survivals were as follows group A, 1/5, group B, 3/5 and group C, 5/5.Group A resulted in abnormal liver function parameters that were significantly ameliorated in group B and C. The histological examination of graft in group A displayed severe pathologic changes including hepatocyte vacuolar change or necrosis, sinusoidal congestion, parenchymal hemorrhage. Affiliating portasystemic shunt significantly alleviated graft injuries in group B and C. PVP rose and peaked up to 28.6 mm Hg (1 mm Hg = 0.133 kPa), PBF fluctuated after reperfusion in group A, but group B and C with affiliating portasystemic shunt showed significantly lower PVP and maintained rather stable PBF after reperfusion. There were also statistical differences in PVP or PBF between group B and C.</p><p><b>CONCLUSIONS</b>Affiliating portasystemic shunt effectively might protect small-for-size graft from injuries after reperfusion.</p>