Model Assisted Analysis of the Hepatic Arterial Buffer Response During <i>Ex Vivo</i> Porcine Liver Perfusion

Becker, Dustin; Onder, Christopher H.; Clavien, Pierre‐Alain; Eshmuminov, Dilmurodjon; Rohr, Philipp Rudolf von; Hefti, Max; Schüler, Martin; Borrego, Lucía Bautista; Hagedorn, Catherine; Muller, Xavier; Graf, Rolf; Dutkowski, Philipp; Tibbitt, Mark W.

doi:10.1109/tbme.2019.2919413

Cited by 16 publications

(20 citation statements)

References 46 publications

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“…When the exact vascular geometry is not required but systemic circulation features are the modeling focus, electrical analog, or 0D models are used, for example, to quantify the hepatic venous pressure gradient (Wang et al, 2017 ), the hepatic arterial buffer response (Ho et al, 2013a ; Becker et al, 2019 ). 0D models have also been used to simulate blood flows in hepatectomy (Yu et al, 2020 ).…”

Section: Multi-dimensional Models For Hepatic Circulationmentioning

confidence: 99%

Virtual Lobule Models Are the Key for Multiscale Biomechanical and Pharmacological Modeling for the Liver

Zhang

2020

Front. Physiol.

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Section: Multi-dimensional Models For Hepatic Circulationmentioning

confidence: 99%

Virtual Lobule Models Are the Key for Multiscale Biomechanical and Pharmacological Modeling for the Liver

Zhang

2020

Front. Physiol.

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“…Such reconstruction is also proposed if the volume of the congestive area in liver remnant exceeds 20% [23]. Recent advances in liver machine perfusions may enable even ex vivo liver resection and vein reconstruction [24][25][26][27]. However, ex vivo liver resection may have the disadvantages of additional warm ischemia during portal and arterial anastomoses and is costly.…”

Section: Discussionmentioning

confidence: 99%

Left renal vein graft and in situ hepatic perfusion in hepatectomy for complete tumor invasion of hepatic veins: hemodynamic optimization and surgical technique

López-López

Garcı́a-López

Eshmuminov³

et al. 2022

Langenbecks Arch Surg

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Purpose Assessing hepatic vein reconstruction using a left renal vein graft and in situ hypothermic liver perfusion in an extended liver resection. Methods Patients included in this study were those with liver tumors undergoing curative surgery with resection and reconstruction of hepatic veins. Hepatic vein was reconstructed using a left renal vein graft. We describe the technical aspects of liver resection and vascular reconstruction, the key aspects of hemodynamic management, and the use of in situ hypothermic liver preservations during liver transection (prior to and during vascular clamping). Results The right hepatic vein was reconstructed with a median left renal venal graft length of 4.5 cm (IQR, 3.1–5.2). Creatinine levels remained within normal limits in the immediate postoperative phase and during follow-up. Median blood loss was 500 ml (IQR, 300–1500) and in situ perfusion with cold ischemia was 67 min (IQR, 60.5–77.5). The grafts remained patent during the follow-up with no signs of thrombosis. No major postoperative complications were observed. Conclusion Left renal vein graft for the reconstruction of a hepatic vein and in situ hypothermic liver perfusion are feasible during extended liver resection.

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“…Previous studies demonstrated that HA resistance increases in response to increased PV flow and vice versa. This phenomenon is coined in the literature as hepatic arterial buffer response (HABR) 7,22 . As this work shows, HA resistance changes www.nature.com/scientificreports/ also depending on oxygen content in the PV.…”

Section: Discussionmentioning

confidence: 99%

Hyperoxia in portal vein causes enhanced vasoconstriction in arterial vascular bed

Eshmuminov¹,

Becker

Hefti

et al. 2020

Sci Rep

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Long-term perfusion of liver grafts outside of the body may enable repair of poor-quality livers that are currently declined for transplantation, mitigating the global shortage of donor livers. In current ex vivo liver perfusion protocols, hyperoxic blood (arterial blood) is commonly delivered in the portal vein (PV). We perfused porcine livers for one week and investigated the effect of and mechanisms behind hyperoxia in the PV on hepatic arterial resistance. Applying PV hyperoxia in porcine livers (n = 5, arterial PV group), we observed an increased need for vasodilator Nitroprussiat (285 ± 162 ml/week) to maintain the reference hepatic artery flow of 0.25 l/min during ex vivo perfusion. With physiologic oxygenation (venous blood) in the PV the need for vasodilator could be reduced to 41 ± 34 ml/week (p = 0.011; n = 5, venous PV group). This phenomenon has not been reported previously, owing to the fact that such experiments are not feasible practically in vivo. We investigated the mechanism of the variation in HA resistance in response to blood oxygen saturation with a focus on the release of vasoactive substances, such as Endothelin 1 (ET-1) and nitric oxide (NO), at the protein and mRNA levels. However, no difference was found between groups for ET-1 and NO release. We propose direct oxygen sensing of endothelial cells and/or increased NO break down rate with hyperoxia as possible explanations for enhanced HA resistance.

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Model Assisted Analysis of the Hepatic Arterial Buffer Response During Ex Vivo Porcine Liver Perfusion

Cited by 16 publications

References 46 publications

Virtual Lobule Models Are the Key for Multiscale Biomechanical and Pharmacological Modeling for the Liver

Virtual Lobule Models Are the Key for Multiscale Biomechanical and Pharmacological Modeling for the Liver

Left renal vein graft and in situ hepatic perfusion in hepatectomy for complete tumor invasion of hepatic veins: hemodynamic optimization and surgical technique

Hyperoxia in portal vein causes enhanced vasoconstriction in arterial vascular bed

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