The Portosystemic Shunt Protects the Liver Against Ischemic Reperfusion Injury.

Sankary, Howard; Yin, Dengping; Chong, Anita S.; Ma, Lianli; Blinder, Leonard; Shen, Jikun; Foster, Patricia L.; Liu, L.; Li, C.; Williams, James W.

doi:10.1097/00007890-199905150-00451

Cited by 22 publications

(32 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…p38 MAP kinase mediates intracellular stress-activated signaling pathways such as those leading to macrophage proinflammatory cytokine production. On the other hand, hepatic ischemia/reperfusion induces nuclear factor kappa B (NFÎB) activation [35,36]. NFÎB is involved in the regulation of many proinflammatory genes, e.g.…”

Section: Discussionmentioning

confidence: 99%

Attenuation of Liver and Lung Injury after Hepatic Ischemia and Reperfusion by a Cytokine-Suppressive Agent, FR167653

et al. 2001

View full text Add to dashboard Cite

Background: Hepatic ischemia/reperfusion (I/R) injury is an important clinical problem and leads to the release of the proinflammatory cytokines, TNF-α and IL-1. These cytokines play important roles in the induction of polymorphonuclear neutrophil (PMN) activation and infiltration, and induce not only localized hepatic injury but also remote organ injury, especially pulmonary injury. Using a total hepatic ischemia model in rats, we tested our hypothesis that suppression of TNF-α and IL-1 by FR167653 ameliorates I/R injury in the liver and lung. Methods: Male Wistar rats, weighing 240–280 g, were divided into 3 groups, an FR group, a control group and a sham group. In the FR group, FR167653 (1 mg/kg/h) was administered continuously to the animals for 30 min prior to the onset of ischemia and for 2 h after reperfusion. The control group received normal saline. A porto-systemic shunt was placed between the cecal branch of the portal vein and the jugular vein, and total hepatic ischemia was produced for 90 min. The sham group was treated with placement of the porto-systemic shunt only. The 1-week survival rate, liver enzyme activity, hepatic tissue blood flow (HTBF), cytokine mRNA expression, myeloperoxidase (MPO) activity and histological results were studied. Results: The 1-week survival rate and HTBF were significantly higher in the FR group than in the control group. Serum AST, ALT, and LDH levels were significantly lower in the FR group at 30 min, 1 h and 3 h after reperfusion. MPO levels in liver and lung tissue were also significantly lower in the FR group. The expression of IL-1β mRNA remarkably decreased up to 6 h after reperfusion in the FR group. Conclusions: We concluded that the inflammatory cytokines, IL-1β, play important roles in hepatic I/R injury. FR167653 might ameliorate I/R injury and be useful in liver surgery with ischemia.

show abstract

Section: Discussionmentioning

confidence: 99%

Attenuation of Liver and Lung Injury after Hepatic Ischemia and Reperfusion by a Cytokine-Suppressive Agent, FR167653

et al. 2001

View full text Add to dashboard Cite

show abstract

“…This lead to the impetus for various investigators to seek alternative methods to attenuate splanchnic venous stasis. Portacaval shunt, splenocaval shunt, extracorporeal PSS, and clamping of the celiac and superior mesenteric arteries are methods used for this purpose [3][4][5]9]. Suzuki et al [15] performed intracorporeal anastomosis between the splenic vein and inferior vena cava.…”

Section: Discussionmentioning

confidence: 99%

“…Their results showed that 60 min of warm ischemia of the liver in the rat is tolerable when the intestinal blood is shunted into systemic circulation. Sankary et al [4] reported that rats subjected to 120 min of normothermic liver ischemia survived for more than 1 day when a splenocaval shunt was applied. In our study, we performed an extracorporeal PSS by placing a polyethylene tube between a cecal branch of the portal vein and a jugular vein.…”

Section: Discussionmentioning

confidence: 99%

“…This maneuver reduces blood loss and operating time, but damage to the liver and other organs has been noted [1][2][3]. Prolonged clamping of the portal vein has been shown to induce different negative pathophysiological events, such as release of endotoxin, tumor necrosis factor (TNF), damage to the intestinal mucosa, and bacterial translocation [1,[3][4][5]. Many of these adverse effects are related to damage to the gut owing to prolonged splanchnic venous stasis.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Portosystemic Shunt Prevents Apoptosis in Rat Intestinal Mucosa Caused by Total Hepatic Ischemia

Bedirli

Şakrak²,

Soyuer³

et al. 2004

Eur Surg Res

View full text Add to dashboard Cite

Background: Prolonged splanchnic congestion due to total hepatic ischemia (THI) has been shown to induce damage to the intestinal mucosa. The present study was conducted to examine whether the protective effect of portosystemic shunt (PSS) can be seen on apoptosis of intestinal mucosa in a rat model of THI. Methods:Adult male Wistar rats were divided into the following 3 groups: control group; the THI group underwent THI for 30 min, and the PSS group was subjected to THI for 30 min with PSS. Rats were killed after 1, 2, and 6 h of reperfusion. For each time point, levels of serum liver enzymes, intestinal morphology, malondialdehyde (MDA) contents and DNA fragmentation in intestinal tissue were determined. In addition, the 7-day survival rate was measured. Results: The 7-day survival rate of THI group remained at 50%, whereas that of PSS group was significantly higher at 90% (p < 0.01). Serum AST and ALT levels of the THI and PSS groups rapidly increased after reperfusion, reaching peak values at 2 h. MDA levels after 1 and 2 h of reperfusion in the THI group were significantly increased as compared with the control group (p < 0.001). Increases in the percentage of fragmented DNA peaked 1 h after reperfusion in the THI group. PSS resulted in the reduction of DNA fragmentation and preserved the macroscopic and microscopic appearance of the intestinal mucosa. Conclusions: Splanchnic congestion due to portal occlusion increased apoptosis in the rat intestinal mucosa. PSS is very effective in counteracting the principal negative effects of total hepatic ischemia.

show abstract

“…Sim-ilarly, during massive hepatectomy in rats a detrimental effect has been attributed to the dramatic increase in portal flow through the small remnant [9] . The hepatoprotective action of PCS has been demonstrated in rat models of warm ischemia and massive hepatectomy [10,11] .…”

Section: Introductionmentioning

confidence: 99%

Effect of the Portacaval Shunt on Reperfusion Injury after 65% Hepatectomy in Pigs

et al. 2008

View full text Add to dashboard Cite

Background: Portal flow diversion by portacaval shunts (PCS) has been shown to prevent primary graft nonfunction in liver transplantation using small-for-size grafts. In this study, we examine whether PCS can improve reperfusion injury after major hepatectomy in pigs. Materials and Methods: In 14 pigs, a partial PCS was constructed following 65% hepatectomy and 1 h of inflow ischemia. During 24 h of reperfusion, the shunt was either closed (group A, n = 7) or left open (group B, n = 7). Results: 24 h after reperfusion, group A had higher levels of alanine aminotransferase (70 ± 12 IU/l vs. 51 ± 5.9 IU/l; p < 0.05), alanine aminotransferase per gram of liver remnant (0.41 ± 0.07 IU/l/g vs. 0.21 ± 0.05 IU/l/g; p < 0.05), prothrombin time (24.1 ± 2.4 s vs. 14.3 ± 2.9 s; p < 0.05), international normalized ratio (2.11 ± 0.15 vs. 1.29 ± 0.28; p < 0.05), hepatocyte necrosis scores and percentages of nuclei stained for proliferating cell nuclear antigen (52.57 ± 8.9% vs. 36.71 ± 6%; p < 0.05) compared to group B. Conclusions: Partial portal flow diversion appears to attenuate reperfusion injury in a porcine model of major hepatectomy.

show abstract

The Portosystemic Shunt Protects the Liver Against Ischemic Reperfusion Injury.

Cited by 22 publications

References 0 publications

Attenuation of Liver and Lung Injury after Hepatic Ischemia and Reperfusion by a Cytokine-Suppressive Agent, FR167653

Attenuation of Liver and Lung Injury after Hepatic Ischemia and Reperfusion by a Cytokine-Suppressive Agent, FR167653

Portosystemic Shunt Prevents Apoptosis in Rat Intestinal Mucosa Caused by Total Hepatic Ischemia

Effect of the Portacaval Shunt on Reperfusion Injury after 65% Hepatectomy in Pigs

Contact Info

Product

Resources

About