gms | German Medical Science

The safe limit of liver volume in partial liver transplantation and extended hepatic resection still remains to be clarified. In small animal models a portosystemic shunt reducing portal hyperperfusion has been shown to be beneficial to the early sinusoid damage after liver resection. Pigs, however, a model with a liver of similar physical size to that of the human, has seldom been used.

An extended left hemihepatectomy (approximately 75% of liver volume) was performed in 16 6 to 8 weeks old domestic pigs (body weight 25 - 35 kg), divided into two groups: the control group with extended hepatic resection alone (n=8) and the shunt group (n=8) with liver resection and a portosystemic H-shunt, inserted between the portal vein and the infrahepatic vena cava prior to hepatectomy. After surgery the animals were weaned from anesthesia and resumed oral feeding ad libidum after recovery. Liver biopsies and blood samples (ALT, AST, Bilirubin, LDH, PT) were examined before closure of the abdominal wall and every second day until death or sacrification.

Extended left hemihepatectomy was technically feasable in all animals. Six animals in the control group and 5 in the study group survived day 7. Hypertrophy of the remnant right lateral segment reached 250% in both groups at the end of the study period. Histological workup demostrated no significant difference regarding steatosis, liver cell necrosis and inflammatory response with a trend towards less steatosis and infiltration in the control group. Liver function and transaminases were also similar in both groups.

Although portal hyperperfusion in extended liver resection was reduced by portosystemic shunt no significant difference in liver hypertrophy, histology and liver function tests was found.