Modeling the impact of partial hepatectomy on the hepatic hemodynamics using a rat model.

Due to the growing shortage of donor livers, more patients are waiting for transplantation. Living donor liver transplantation may help expanding the donor pool, but is often confronted with the small-for-size syndrome. Since the hemodynamic effects of partial hepatectomy are not fully understood, we developed an electrical rat liver model to compare normal with resected liver hemodynamics. Detailed geometrical data and 3-D reconstructions of the liver vasculature of two rats were gathered by combining vascular corrosion casting, micro-CT scanning, and image processing. Data extrapolations allowed obtaining a total liver pressure- and flow-driven electrical analog. Subsequently, virtual resections led to 70%, 80%, or 90% partial hepatectomy models. Results demonstrated hyperperfusion effects such as portal hypertension and elevated lobe-specific portal venous flows (11, 12, and 24 mmHg, and 1.0-3.0, 1.8-3.5, and 7.4 ml/min for 70%, 80%, and 90% hepatectomy, respectively). Comparison of two 90% resection techniques demonstrated different total arterial flows (0.28 ml/min versus 0.61 ml/min), portal (24 mmHg versus 21 mmHg), and sinusoidal pressures (14 mmHg versus 9.5-12 mmHg), probably leading to better survival for lower portal and sinusoidal pressures. Toward the future, the models may be extrapolated to human livers and help us to optimize hepatectomy planning.