Effects of cyclosporine A and prednisone treatment on mixed meal disposition in dogs with hepatic denervation

Moore, MC; Cherrington, AD; Palmer, Brett; Lacy, D. Brooks; Goldstein, R. E.

doi:10.1177/014860710202600142

Cited by 4 publications

(2 citation statements)

References 40 publications

(53 reference statements)

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“…Hepatic cholinergic nerves are necessary for normal glucose response to insulin (Xue et al, 2000), hepatic glucose production in the postabsorptive state, and hepatic glucose uptake in the postprandial state (Matsuhisa et al, 2000). Moore et al (2002a) did not find any difference in postprandial hyperglycemia and insulin resistance between dogs receiving ciclosporine, prednisolone, and hepatic denervation or sham‐operation.…”

Section: Effect Of Hepatic Denervation In Experimental Animal Modelsmentioning

confidence: 95%

Transplanted liver: Consequences of denervation for liver functions

et al. 2004

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Following liver transplantation, all hepatic nerves are transected; thus, liver allografts are completely isolated from neural control of their hosts. Despite this absolute denervation, liver allograft function does not appear to be significantly impaired after successful transplantation. In experimental animal models, hepatic denervation has no major effects on bile acid production and biotransformation, while it increases blood pressure and salt retention; decreases the number of hepatic progenitor cells, cholangiocyte proliferation, and liver regeneration; and influences the hepatic microcirculation, diet behavior, and glycemic control. In humans, hepatic denervation after liver transplantation has no major deleterious effects on bile secretion, liver regeneration, and hepatic blood flow. Insulin resistance and postprandial hyperglycemia, changes in ingestion behavior, and reduced stimulation of hepatic progenitor cells in the canals of Hering are the major side effects of absent liver innervation. Despite these abnormalities, patients can lead a new life with improved quality of life. © 2004 Wiley-Liss, Inc. Key words: liver transplantation; denervation; function; hepaticLiver transplantation is the ultimate treatment for patients with acute fulminant and chronic liver failure. The results of liver transplantation are good, with a 1-year survival of 90 -95% and a 10-year survival of 50 -60%. Because of a shortage in cadaveric donors, living-related liver transplantation is a good option to overcome this problem.The autonomic nerves of the liver are formed by an anterior plexus (around the hepatic artery) and a posterior plexus (surrounds portal vein and bile duct). Parasympathetic nerves are derived from the vagus nerve and the sympathetic fibers from the celiac ganglion. Sensory nerve endings are present in the liver capsule, central veins, and bile ducts. Most of the afferent nerves from the liver run via the vagus and splanchnic nerves, but some also to the right phrenic nerve. The afferent nerves register information from nocireceptors, osmo-and baroreceptors, as well as ionic and metabolic receptors (Bathal and Grossman, 1999).Following liver transplantation, the hepatic nerves are inevitably transected below the porta hepatis or at the hepatoduodenal ligament; thus, liver allografts are completely isolated from the neural control of their hosts. Despite this absolute denervation, the liver allograft does not appear to be significantly compromised after successful transplantation. There is no obvious deficiency in the regulation of liver metabolism (production of proteins such as albumin and coagulation factors, metabolization) and bile production. At first blush, it seems that under normal circumstances, hormones and substrates reaching the liver by circulation are responsible for control of the organ function, and that the role of hepatic nerves is mainly restricted to situations of physiological stress.However, a more profound search revealed that hepatic denervation has a lot of consequences...

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Section: Effect Of Hepatic Denervation In Experimental Animal Modelsmentioning

confidence: 95%

Transplanted liver: Consequences of denervation for liver functions

et al. 2004

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“…Numerous models of liver transplant showed that the counterregulatory response to insulin‐induced hypoglycemia or exercise (swimming and running) is normal (Jackson et al, 2000; Latour et al, 1985; Lindfeldt et al, 1993; Moore et al, 1993). Although increased hypoglycemic incidence does not appear to be a complication in those patients, there are numerous conflicting factors (such as the use of corticosteroids or immunosuppressive agents) which complicate interpretation of the data (Luzi et al, 1997; Moore et al, 2002). On the other hand, studies investigating the importance of brain hypoglycemia to the counterregulatory response using glucose infusion into the carotid and vertebral arteries (Biggers et al, 1989; Winnick et al, 2016) showed that the brain appeared to play a major role in coordinating the hormonal response to hypoglycemia.…”

Section: Discussionmentioning

confidence: 99%

Safety of surgical denervation of the common hepatic artery in insulin‐resistant dogs

et al. 2021

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Fiberoptic endoscopic evaluation of swallowing in intensive care unit patients

Hafner

Neuhuber

Hirtenfelder

et al. 2007

Eur Arch Otorhinolaryngol

107

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Aspiration in critically ill patients frequently causes severe co-morbidity. We evaluated a diagnostic protocol using routine FEES in critically ill patients at risk to develop aspiration following extubation. We instructed intensive care unit physicians on speciWc risk factors for and clinical signs of aspiration following extubation in critically ill patients and oVered bedside FEES for such patients. Over a 45-month period, we were called to perform 913 endoscopic examinations in 553 patients. Silent aspiration or aspiration with acute symptoms (cough or gag reXex as the bolus passed into the trachea) was detected in 69.3% of all patients. Prolonged non-oral feeding via a naso-gastric tube was initiated in 49.7% of all patients. In 13.2% of patients, a percutaneous endoscopic gastrostomy was initiated as a result of FEES Wndings, and in 6.3% an additional tracheotomy to prevent aspiration had to be initiated. In 59 out of 258 patients (22.9%), tracheotomies were closed, and 30.7% of all 553 patients could be managed with the immediate onset of an oral diet and compensatory treatment procedures. Additional radiological examinations were not required. FEES in critically ill patients allows for a rapid evaluation of deglutition and for the immediate initiation of symptom-related rehabilitation or for an early resumption of oral feeding.

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Effects of cyclosporine A and prednisone treatment on mixed meal disposition in dogs with hepatic denervation

Abstract: Immunosuppressive therapy is responsible for most of the alterations in postprandial carbohydrate metabolism observed in this model; the lack of hepatic nerves has little additional impact.

Cited by 4 publications

References 40 publications

Transplanted liver: Consequences of denervation for liver functions

Transplanted liver: Consequences of denervation for liver functions

Safety of surgical denervation of the common hepatic artery in insulin‐resistant dogs

Fiberoptic endoscopic evaluation of swallowing in intensive care unit patients

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