This paper is only available as a PDF. To read, Please Download here.
Abstract
Background. To evaluate new therapies for human fulminant hepatic failure, a suitable large animal
model is needed. The purpose of this study was to develop a reversible surgical model
of acute hepatic liver failure by transient ischemia in pigs.
Materials and methods. Under general anesthesia, an end-to-side portacaval shunt was performed in 17 pigs
and tape was laid around the hepatoduodenal ligament. Two days after construction
of the functional portacaval shunt, 13 ambulant pigs underwent transient total liver
ischemia by tightening of the tape around the hepatoduodenal ligament for 5.5 h. During
ischemia, 10% glucose was continuously infused intravenously to prevent hypoglycemia.
Results. Ten animals (77%) died with hepatic coma after a mean duration of 22.5 ± 1.9 h. The
3 remaining animals survived more than 5 days and were sacrificed. In dying animals,
encephalopathy was observed 14 ± 1.7 h after the onset of ischemia. During ischemia,
similar progressive decrease of fibrinogen, platelets, prothrombin time, and factors
V and VII activities was observed in dying and surviving animals. Just before death,
mean prothrombin and factors V and VII activities were respectively 22 ± 2, 21 ± 4.4,
and 24 ± 5%. At 22 h, plasma ammonia and lactate levels were respectively 705 ± 93
μmol/L and 10.5 ± 0.4 mmol/L in dying animals and 249 ± 75 μmol/L and 2.9 ± 0.1 mmol/L
in surviving animals (P < 0.01). Estimation of the percentage liver cells necrosed was 74 ± 4.7% in the survivors
and 86 ± 5.5% in animals who died of hepatic coma (NS).
Conclusions. This model is reproducible and reversible and should allow the quantitative evaluation
of new technologies, such as bioartificial liver, for the support of hepatic failure
in humans.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Surgical ResearchAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
REFERENCES
- Acute liver failure.N. Engl. J. Med. 1993; 329: 1862
- Liver transplantation in patients with fulminant hepatic failure.Br. J. Surg. 1995; 82: 118
- Orthotopic liver transplantation in fulminant and subfulminant hepatitis. The Paul Brousse experience.Ann. Surg. 1995; 222: 109
- Auxiliary liver transplantation: Regeneration of the native liver and outcome in 30 patients with fulminant hepatic failure.Hepatology. 1996; 23: 1119
- A bioartificial liver to treat severe acute liver failure.Ann. Surg. 1994; 219: 538
- Reversal of fulminant hepatic failure using an extracorporeal liver assist device.Hepatology. 1992; 16: 60
- Hepatocyte transplantation as a bridge to orthotopic liver transplantation in terminal liver failure.Transplantation. 1997; 63: 559
- Human fetal hepatocyte transplantation in patients with hepatic failure.Transplantation. 1994; 58: 951
- The anhepatic model in a pig.S. A. Med. J. 1974; 48: 263
- A new technique for preparing totally hepatectomized pigs.Surgery. 1973; 73: 463
- Preclinical trial of a bioartificial liver support system in a porcine fulminant hepatic failure model.Aust. N. Z. J. Surg. 1996; 66: 547
- Coma hépatique expérimental par nécrose ischémique aiguë du foie chez le porc.J. Chir. 1972; 103: 63
- Acute liver failure due to temporary hepatic ischemia in the pig.Acta Hépato-Gastroenterol. 1976; 23: 241
- A reproducible model of acute hepatic failure by transient ischemia in the pig.J. Surg. Res. 1987; 42: 92
- Fulminant and subfulminant hepatic failure: Definition and causes.Semin. Liver Dis. 1986; 6: 97
- Animal experience with support systems: Are these appropriate animal models of fulminant hepatic neurosis.in: Williams R. Mung-Lyon I. Artificial Liver Support. Pitman, London1975: 163-172
- Acute hepatic coma: A canine model.Surgery. 1972; 72: 634
- An animal model of fulminant hepatic failure: A feasibility study.Gastroenterology. 1976; 71: 109
- An improved model of acetaminophen-induced fulminant hepatic failure in dogs.Hepatology. 1992; 15: 329
- An anesthetized model of lethal canine galactosamine fulminant hepatic failure.Hepatology. 1995; 21: 796
- Hepatotoxicity of d-galactosamine in the isolated perfused rat liver.Exp. Mol. Pathol. 1980; 32: 264
- A new surgical model of acute liver failure in the pig: Experimental procedure and analysis of liver injury.Eur. Surg. Res. 1991; 23: 58
Article info
Identification
Copyright
© 2000 Academic Press. Published by Elsevier Inc. All rights reserved.