Hye-Sung Jo1, Hyun-Jin Park2, Yoon Young Choi2, Jin-I Seok2, Jae-Hyun Han3, Young-In Yoon4, Dong-Sik Kim1. 1. Division of HBP Surgery and Liver Transplantation, Department of Surgery, Korea University College of Medicine Seoul, Korea. 2. Department of Biomedical Science, Korea University College of Medicine Graduate School Seoul, Korea. 3. Department of Surgery, College of Medicine, St. Vincent's Hospital, The Catholic University of Korea Seoul, Korea. 4. Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine Seoul, Korea.
Abstract
BACKGROUND: Excessive postoperative portal pressure is associated with post-hepatectomy liver failure and small-for-size syndrome after partial liver transplantation. This study aimed to identify the portal modulation effects of terlipressin on liver regeneration and survival in a porcine model subjected to 90% hepatectomy. METHODS: Twenty pigs undergoing 90% hepatectomy were divided into control (n = 10) and terlipressin (n = 10) groups. Terlipressin 0.5 mg was injected subcutaneously three times a day, from immediately before hepatectomy to 7 days after surgery, for surviving pigs in the terlipressin group. Portal pressure measurement, biochemical analysis, assessment of molecular markers for liver regeneration, and immunohistochemistry were performed in both groups. RESULTS: The 7-day survival rate was significantly higher in the terlipressin group than that in the control group. Portal pressure in the terlipressin group was lower than that in the control group at 30 min and 1 h after hepatectomy. Total bilirubin level was lower in the terlipressin group than that in the control group at 1 h and 6 h after hepatectomy. Proliferating cell nuclear antigen expression was higher in the control group than that in the terlipressin group at 6 h after hepatectomy, while the proportion of Ki-67-positive cells was higher in the terlipressin group than that in the control group at 7 days after hepatectomy. Endothelin-1 level reflecting liver injury was lower in the terlipressin group than that in the control group at 1 h and 6 h after hepatectomy. CONCLUSION: Terlipressin could optimize liver regeneration and improve survival through rapid and effective portal modulation after extensive hepatectomy. AJTR
BACKGROUND: Excessive postoperative portal pressure is associated with post-hepatectomy liver failure and small-for-size syndrome after partial liver transplantation. This study aimed to identify the portal modulation effects of terlipressin on liver regeneration and survival in a porcine model subjected to 90% hepatectomy. METHODS: Twenty pigs undergoing 90% hepatectomy were divided into control (n = 10) and terlipressin (n = 10) groups. Terlipressin 0.5 mg was injected subcutaneously three times a day, from immediately before hepatectomy to 7 days after surgery, for surviving pigs in the terlipressin group. Portal pressure measurement, biochemical analysis, assessment of molecular markers for liver regeneration, and immunohistochemistry were performed in both groups. RESULTS: The 7-day survival rate was significantly higher in the terlipressin group than that in the control group. Portal pressure in the terlipressin group was lower than that in the control group at 30 min and 1 h after hepatectomy. Total bilirubin level was lower in the terlipressin group than that in the control group at 1 h and 6 h after hepatectomy. Proliferating cell nuclear antigen expression was higher in the control group than that in the terlipressin group at 6 h after hepatectomy, while the proportion of Ki-67-positive cells was higher in the terlipressin group than that in the control group at 7 days after hepatectomy. Endothelin-1 level reflecting liver injury was lower in the terlipressin group than that in the control group at 1 h and 6 h after hepatectomy. CONCLUSION: Terlipressin could optimize liver regeneration and improve survival through rapid and effective portal modulation after extensive hepatectomy. AJTR
Authors: A Escorsell; L Ruiz del Arbol; R Planas; A Albillos; R Bañares; P Calès; D Pateron; B Bernard; J P Vinel; J Bosch Journal: Hepatology Date: 2000-09 Impact factor: 17.425
Authors: Dong-Sik Kim; Woong Bae Ji; Jae Hyun Han; Yoon Young Choi; Hyun-Jin Park; Young-Dong Yu; Ju Young Kim Journal: Ann Surg Treat Res Date: 2018-02-28 Impact factor: 1.859