PERIOPERATIVE INTERVENTIONS ENHANCES SURVIVAL AND LIVER REGENERATION FOLLOWING EXTENSIVE PORTAL BRANCH LIGATION OF RABBIT LIVER

Aim: The purpose of this study was to evaluate the effect of pharmacologic interventions in preventing liver injury, enhancing liver regeneration and prolonging survival following portal vein ligation to 80% of the liver parenchyma. Methods: Rabbits underwent ligation of the portal vein branches to 80% liver parenchyma. One group of animals served as a control. The other group received pharmacologic interventions. Interventions consisted of postoperative oral 20% glucose supplementation to prevent postoperative hypoglycemia, perioperative low-molecular-weight heparin to prevent intrasinusoidal thrombosis and oral antibiotic to prevent bacterial translocation with their injurious effect on liver remnant and hepatocyte proliferation. Outcome measurements included serum liver function tests, glucose levels, and histological assessment of hepatocyte necrosis, apoptosis, mitosis and intrasinusoidal fibrin deposition and length of postoperative survival. Results: Interventions improved survival in the treated group (1.07±0.07 days versus 0.71±0.1 days). Hepatocyte necrosis (31.1+0.02 versus 51.5±0.02), apoptosis (30.4±0.02 versus 40.7 ±0.03) and intrasinusoidal fibrin deposition (5.6±0.8 versus 8.7±1.0) were significantly decreased and mitotic figures (29.1±2.7 versus 15.7±1.2) significantly increased in the treated group compared to control group. Biochemical markers of hepatocyte injury were not different among groups. Conclusion: Pharmacologic interventions improve survival and histological evidence of remnant liver regeneration in animals subjected to portal branch ligation to 80% of rabbit liver