The Porcine Hepatic Arterial Supply, Its Variations and Their Influence on the Extracorporeal Perfusion of the Liver

Gravante, Gianpiero; Ong, Seok Ling; Metcalfe, Matthew S.; Lloyd, David M.; Dennison, Ashley R.

doi:10.1016/j.jss.2009.09.050

Cited by 13 publications

(12 citation statements)

References 15 publications

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“…This phenomenon raised the suspicion of non-perfused zones derived from a peculiar arterial supply and meticulous dissections of the hepatic hilum confirmed this hypothesis showing multiple variable branches of the hepatic artery [15]. Such variations required more proximal cannulations of the hepatic artery, from the celiac trunk, to include all branches in the perfusion [15]. From the first experiments it was also clear that the circuit was haemodynamically unstable during the first hour of perfusion and that this phenomenon produced a higher variability of the parameters measured compared to the rest of the perfusion [3,14].…”

Section: Discussionmentioning

confidence: 72%

“…The initial technical challenge consisted in the partial perfusion of the liver as the organ constantly developed a clear demarcation line over the hours. This phenomenon raised the suspicion of non-perfused zones derived from a peculiar arterial supply and meticulous dissections of the hepatic hilum confirmed this hypothesis showing multiple variable branches of the hepatic artery [15]. Such variations required more proximal cannulations of the hepatic artery, from the celiac trunk, to include all branches in the perfusion [15].…”

Section: Discussionmentioning

confidence: 83%

“…Since 2007 our group has adapted the harvesting technique to improve the organ perfusion according to the variations of the porcine hepatic arterial supply [15] and has conducted various studies to investigate the inflammatory, biochemical and histological modifications during the ex vivo perfusions [1,3,11,12,14]. From the beginning it was evident that different metabolic products tended to accumulate in the circuit over the hours despite our efforts to control the biochemical milieu by administering counteracting substances (i.e., bicarbonate and insulin) [11,14].…”

Section: Introductionmentioning

confidence: 99%

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The “kidney–liver” multiorgan ex vivo perfused model improves the circuit’s biochemical milieu during perfusion compared to the “liver–kidney” counterpart

et al. 2015

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The multiorgan ex vivo perfused liver-kidney model allows studying the hepatic pathophysiology and purifying waste products. We tested if the addition of the kidney first followed by the liver (KL circuit) produces better results compared to the classic liver-first approach (LK). Intact livers and kidneys were obtained post mortem from ten female domestic white pigs, five experiments were conducted with the KL circuit and five with the LK. Bile, urine production, arterial blood gases, glucose, renal and liver tests were collected hourly during the perfusions. The KL circuit had values more close to physiological ranges, more stable over time and showed less variability compared to the LK circuit for urine production, glucose, PH, anion gap, lactate, urea, sodium, potassium and Alanine Transaminase (ANOVA test for repeated measures p < 0.05). The KL circuit produced a more physiological and reliable biochemical milieu.

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Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 83%

Section: Introductionmentioning

confidence: 99%

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The “kidney–liver” multiorgan ex vivo perfused model improves the circuit’s biochemical milieu during perfusion compared to the “liver–kidney” counterpart

et al. 2015

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“…The performed experiments elucidated several considerations for further refinement of the experimental setup for simultaneous dual input liver perfusion and is the subject of future work. Finally, it must be noted that both an understanding of the porcine hepatic vascular anatomy 38 and careful initial surgical dissection and perfusion-fixation of the liver are critical to the success of the phantom for later experimentation.…”

Section: Discussionmentioning

confidence: 99%

Porcine Ex Vivo Liver Phantom for Dynamic Contrast-Enhanced Computed Tomography

Thompson¹,

Ramírez-Giraldo²,

Knudsen³

et al. 2011

Investigative Radiology

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Objectives To demonstrate the feasibility of developing a fixed, dual-input, biological liver phantom for dynamic contrast-enhanced computed tomography (CT) imaging and to report initial results of use of the phantom for quantitative CT perfusion imaging. Materials and Methods Porcine livers were obtained from completed surgical studies and perfused with saline and fixative. The phantom was placed in a body-shaped, CT-compatible acrylic container and connected to a perfusion circuit fitted with a contrast injection port. Flow-controlled contrast-enhanced imaging experiments were performed using a 128-slice and 64 slice, dual-source multidetector CT scanners. CT angiography protocols were employed to obtain portal venous and hepatic arterial vascular enhancement, reproduced over a period of four to six months. CT perfusion protocols were employed at different input flow rates to correlate input flow with calculated tissue perfusion, to test reproducibility and demonstrate the feasibility of simultaneous dual input liver perfusion. Histologic analysis of the liver phantom was also performed. Results CT angiogram 3D reconstructions demonstrated homogenous tertiary and quaternary branching of the portal venous system out to the periphery of all lobes of the liver as well as enhancement of the hepatic arterial system to all lobes of the liver and gallbladder throughout the study period. For perfusion CT, the correlation between the calculated mean tissue perfusion in a volume of interest and input pump flow rate was excellent (R2 = 0.996) and color blood flow maps demonstrated variations in regional perfusion in a narrow range. Repeat perfusion CT experiments demonstrated reproducible time-attenuation curves and dual-input perfusion CT experiments demonstrated that simultaneous dual input liver perfusion is feasible. Histologic analysis demonstrated that the hepatic microvasculature and architecture appeared intact and well preserved at the completion of four to six months of laboratory experiments and contrast enhanced imaging. Conclusions We have demonstrated successful development of a porcine liver phantom using a flow-controlled extracorporeal perfusion circuit. This phantom exhibited reproducible dynamic contrast-enhanced CT of the hepatic arterial and portal venous system over a four to six month period.

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“…Furthermore, maintaining normal physiological and biochemical parameters for a prolonged period requires a closely monitored perfusion method and model. We have previously described our ex vivo autologous perfused porcine liver model for the study of hepatic physiology and significant progress has been achieved, since we began our liver reperfusion ex vivo model in 2005, in areas such as harvesting technique, understanding hepatic artery anatomical variations 1 , inflammatory response 2,3 , histological changes following liver electrolytic ablation (EA) 4 , and changes in acid base balance during EA 5 . Unfortunately hyperglycemia and metabolic acidosis require external supplements of insulin and bicarbonate to maintain an accurate physiological environment.…”

Section: Introductionmentioning

confidence: 99%

Steps for the Autologous <em>Ex vivo</em> Perfused Porcine Liver-kidney Experiment

Chung

Eltweri

Isherwood

et al. 2013

JoVE

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The use of ex vivo perfused models can mimic the physiological conditions of the liver for short periods, but to maintain normal homeostasis for an extended perfusion period is challenging. We have added the kidney to our previous ex vivo perfused liver experiment model to reproduce a more accurate physiological state for prolonged experiments without using live animals. Five intact livers and kidneys were retrieved postmortem from sacrificed pigs on different days and perfused for a minimum of 6 hr. Hourly arterial blood gases were obtained to analyze pH, lactate, glucose and renal parameters. The primary endpoint was to investigate the effect of adding one kidney to the model on the acid base balance, glucose, and electrolyte levels. The result of this liver-kidney experiment was compared to the results of five previous liver only perfusion models. In summary, with the addition of one kidney to the ex vivo liver circuit, hyperglycemia and metabolic acidosis were improved. In addition this model reproduces the physiological and metabolic responses of the liver sufficiently accurately to obviate the need for the use of live animals. The ex vivo liver-kidney perfusion model can be used as an alternative method in organ specific studies. It provides a disconnection from numerous systemic influences and allows specific and accurate adjustments of arterial and venous pressures and flow. Video LinkThe video component of this article can be found at

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The Porcine Hepatic Arterial Supply, Its Variations and Their Influence on the Extracorporeal Perfusion of the Liver

Cited by 13 publications

References 15 publications

The “kidney–liver” multiorgan ex vivo perfused model improves the circuit’s biochemical milieu during perfusion compared to the “liver–kidney” counterpart

The “kidney–liver” multiorgan ex vivo perfused model improves the circuit’s biochemical milieu during perfusion compared to the “liver–kidney” counterpart

Porcine Ex Vivo Liver Phantom for Dynamic Contrast-Enhanced Computed Tomography

Steps for the Autologous <em>Ex vivo</em> Perfused Porcine Liver-kidney Experiment

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