TY - JOUR
T1 - A Novel Method for the Prevention and Treatment of Small-for-Size Syndrome in Liver Transplantation
AU - Feng, Yanhu
AU - Han, Zhijian
AU - Gu, Baohong
AU - Li, Xuemei
AU - Wang, Bofang
AU - Guo, Facai
AU - Praseedom, Raaj Kumar
AU - Wang, Furong
AU - Cheng, Huijuan
AU - Lucas, Alexandra
AU - Li, Yumin
AU - Chen, Hao
N1 - Funding Information:
We are grateful to the National Natural Science Foundation of China (Nos. 81670594, 81470791, 81376597), Gansu Basic Research Innovation Group Project (No. 1606RJIA328), Gansu Scientific Research of Health Services Project (No. GSWSKY2017-09), Talents Innovation and Entrepreneurship Program of Lanzhou City (No. 2017-RC-62), Talent Staff Fund of the Second Hospital of Lanzhou University (No. ynyjrckyzx2015-1-01, No. ynbskyjj2015-1-08), Cuiying Scientific and Technological Innovation Program of Lanzhou University Second Hospital (No. CY2017-ZD01, No. CY2017-MS05), and Fundamental Research Funds for the Central Universities (lzujbky-2016-k16, lzujbky-2017-79).
Publisher Copyright:
© 2020, Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2020/9/1
Y1 - 2020/9/1
N2 - Background: Currently there is no consensus on the optimal management of small-for-size syndrome following liver transplantation. Here we describe a technique to alleviate portal hypertension and improve the hepatocyte reperfusion in small-for-size liver transplantation in a Lewis rat model. Methods: The rats underwent trans-portal vein intra-hepatic portosystemic shunt using a self-developed porous conical tube (TPIPSS: Fig. 1) on small-for-size liver transplants (SFS) with right lobe graft. The treatment effect was evaluated by comparing hemodynamic parameters, morphological changes, serum parameters, ET-1 and eNOS expression, hepatocyte proliferation and apoptosis, CYP3A2 levels, postoperative complications, and survival between the two groups with SFS liver transplants. Results: Porous conical prosthesis prolonged the filling time of small-for-size grafts. Moreover, grafts with TPIPSS showed a lower portal vein pressure, improved microcirculatory flow, alleviated histological changes, decreased ET-1 and increased eNOS expressions, and significantly less damage to liver function comparing to grafts without TPIPSS. Mean survival and overall 30-day survival were significantly higher in the TPIPSS group. Conclusions: These results demonstrate that porous conical tube as trans-portal vein intra-hepatic portosystemic shunt device is an effective way to alleviate portal vein hypertension and improve hepatocyte reperfusion after small-for-size liver transplantation.
AB - Background: Currently there is no consensus on the optimal management of small-for-size syndrome following liver transplantation. Here we describe a technique to alleviate portal hypertension and improve the hepatocyte reperfusion in small-for-size liver transplantation in a Lewis rat model. Methods: The rats underwent trans-portal vein intra-hepatic portosystemic shunt using a self-developed porous conical tube (TPIPSS: Fig. 1) on small-for-size liver transplants (SFS) with right lobe graft. The treatment effect was evaluated by comparing hemodynamic parameters, morphological changes, serum parameters, ET-1 and eNOS expression, hepatocyte proliferation and apoptosis, CYP3A2 levels, postoperative complications, and survival between the two groups with SFS liver transplants. Results: Porous conical prosthesis prolonged the filling time of small-for-size grafts. Moreover, grafts with TPIPSS showed a lower portal vein pressure, improved microcirculatory flow, alleviated histological changes, decreased ET-1 and increased eNOS expressions, and significantly less damage to liver function comparing to grafts without TPIPSS. Mean survival and overall 30-day survival were significantly higher in the TPIPSS group. Conclusions: These results demonstrate that porous conical tube as trans-portal vein intra-hepatic portosystemic shunt device is an effective way to alleviate portal vein hypertension and improve hepatocyte reperfusion after small-for-size liver transplantation.
KW - Liver transplantation
KW - Porous conical tube
KW - Portal vein hypertension
KW - Small-for-size syndrome
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U2 - 10.1007/s10620-020-06055-2
DO - 10.1007/s10620-020-06055-2
M3 - Article
C2 - 32006210
AN - SCOPUS:85078840370
SN - 0163-2116
VL - 65
SP - 2619
EP - 2629
JO - Digestive Diseases and Sciences
JF - Digestive Diseases and Sciences
IS - 9
ER -