Impact of hepatic vein deprivation on liver regeneration and function after major hepatectomy.
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Impact of hepatic vein deprivation on liver regeneration and function after major hepatectomy. / Bockhorn, Maximilian; Benkö, Tamasz; Opitz, Bettina; Sheu, Sien-Yi; Sotiropoulos, Georgios C; Schlaak, Jörg F; Broelsch, Christoph E; Lang, Hauke.
In: LANGENBECK ARCH SURG, Vol. 393, No. 4, 4, 2008, p. 527-533.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Impact of hepatic vein deprivation on liver regeneration and function after major hepatectomy.
AU - Bockhorn, Maximilian
AU - Benkö, Tamasz
AU - Opitz, Bettina
AU - Sheu, Sien-Yi
AU - Sotiropoulos, Georgios C
AU - Schlaak, Jörg F
AU - Broelsch, Christoph E
AU - Lang, Hauke
PY - 2008
Y1 - 2008
N2 - BACKGROUND AND AIMS: In extended liver resections, the preservation of vascular and biliary structures of the entire remnant liver is of paramount importance. The impact of venous outflow impairment and its consequences for liver regeneration and function are still a matter of debate. MATERIALS AND METHODS: Rats (n = 75) were subjected to a 90% partial hepatectomy (PH), to a 70% liver resection with narrowing of the hepatic outflow of an additional 20% parenchyma (70%+ PH) or to an anatomic 70% PH. Postoperatively hepatocyte proliferation (Ki-67), liver function and survival were assessed. Gene expression analysis for markers of regeneration was determined by in-house complementary (DNA) arrays and quantitative real-time polymerase chain reaction (RT-PCR). RESULTS: Ninety percent PH led to a greater regenerative response as shown Ki-67 compared to animals with a 70%+PH (p <0.05). However, liver function was equally impaired in both groups. Rats with 70% PH showed a greater proliferation index with less hepatic injury and better liver function. While mortality was 0% in the group of 70% PH, rats with 90% PH and 70+PH had a reduced survival of 75% (p <0.05) CONCLUSION: Venous outflow obstruction leads to an impairment of liver regeneration and liver function. In cases with critically small liver remnants, restoration of an adequate venous outflow may be mandatory.
AB - BACKGROUND AND AIMS: In extended liver resections, the preservation of vascular and biliary structures of the entire remnant liver is of paramount importance. The impact of venous outflow impairment and its consequences for liver regeneration and function are still a matter of debate. MATERIALS AND METHODS: Rats (n = 75) were subjected to a 90% partial hepatectomy (PH), to a 70% liver resection with narrowing of the hepatic outflow of an additional 20% parenchyma (70%+ PH) or to an anatomic 70% PH. Postoperatively hepatocyte proliferation (Ki-67), liver function and survival were assessed. Gene expression analysis for markers of regeneration was determined by in-house complementary (DNA) arrays and quantitative real-time polymerase chain reaction (RT-PCR). RESULTS: Ninety percent PH led to a greater regenerative response as shown Ki-67 compared to animals with a 70%+PH (p <0.05). However, liver function was equally impaired in both groups. Rats with 70% PH showed a greater proliferation index with less hepatic injury and better liver function. While mortality was 0% in the group of 70% PH, rats with 90% PH and 70+PH had a reduced survival of 75% (p <0.05) CONCLUSION: Venous outflow obstruction leads to an impairment of liver regeneration and liver function. In cases with critically small liver remnants, restoration of an adequate venous outflow may be mandatory.
M3 - SCORING: Zeitschriftenaufsatz
VL - 393
SP - 527
EP - 533
JO - LANGENBECK ARCH SURG
JF - LANGENBECK ARCH SURG
SN - 1435-2443
IS - 4
M1 - 4
ER -
