Abstract
Background: Arterialization of the portal vein has been propagated as a technical variant in liver transplantation. However, the consequences of this unphysiological vascular supply are insufficiently known. Methods: 27 healthy pigs were subjected to a left hemihepatectomy and divided into 3 groups. The first group received complete arterialization of the portal vein (PVA). In the second group hepatic artery blood flow was interrupted by division in addition (PVA/DHA). Nine animals served as controls (Group C). Results: In comparison with the controls, arterialization (PVA and PVA/DHA) led to significantly faster hepatic regeneration with comparable liver function, with increases of liver size to 278% and 293% vs. 134% (p = 0.002) after 3 weeks. This was accompanied by enhanced hepatic expression of the proliferation markers MIB-1 (22.4% and 16.7% vs. 5.9%, p = 0.002) and PCNA (86% and 68% vs. 66%, p = 0.002) one week post-operation. In parallel, the number of apoptotic hepatocytes increased from 1.6% to 2.5% and 2.3% (p = 0.002). No significant difference was found in the collagen content of the livers after 3 weeks. Conclusions: PVA promotes early hepatic regeneration, especially in reduced-size or split grafts. However, development of fibrosis in the long-term may preclude its use for orthotopic transplantation, whereas it appears to be useful for auxiliary transplantation.
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