Abstract
This study aimed to investigate the effect of the dual arterial blood supply method used in auxiliary liver transplantation on the regeneration of grafted and host liver. A total of 72 male Sprague-Dawley rats were randomly assigned to three experimental groups, namely the 68% hepatectomy group (group A), the 68% hepatectomy with dual arterial blood supply group (group B) and the auxiliary liver transplantation with dual arterial blood supply group (group C). Group C was further divided into the host liver subgroup (group Ca) and the transplanted liver subgroup (group Cb). Six animals from each group were sacrificed at 1, 2 and 7 days after surgery. The calculation of the liver regeneration rate (LRR) was based on measuring liver weight. Liver function was assessed by measuring serum alanine aminotransferase (ALT) levels. Immunohistochemistry was employed to detect the expression of proliferating cell nuclear antigen (PCNA). Apoptotic changes in the grafts and host livers were evaluated using TUNEL staining. The LRR in each group exhibited a tendency to increase over time. At each time point, the LRR of transplanted livers in group C exhibited no significant difference from that of host livers in group C (P>0.05). The ALT levels for each group exhibited a time-dependent decreasing tendency. The ALT level in group C was significantly higher compared to that in groups A and B at each time point (P<0.05). The expression of PCNA in transplanted and host livers in group C was significantly lower compared to that in groups A and B at the same time point (P<0.001). Although the number of apoptotic cells in each group varied at different time points, there was no statistically significant difference (P>0.05). In auxiliary liver transplantation with the dual arterial blood supply method, the capacity of the liver regeneration in the grafts was similar to that of the host livers. Therefore, this technique may reduce the potential risk of graft liver atrophy caused by functional competition.
Highlights
Dual arterial blood supply in the liver is the technique of using other arteries to completely or partially replace blood supply from the portal venous system
The questions of whether the regeneration in the grafted and host livers in auxiliary liver transplantation is distinguished from that in conventional partial hepatectomy and of whether the interaction between the donor and host livers leads to the regenerative changes were raised [3]
It was previously demonstrated that the arterialized blood flow in 68% hepatectomy with dual hepatic arterial blood supply was similar to the normal physiological flow of the portal vein [10]
Summary
Dual arterial blood supply in the liver is the technique of using other arteries to completely or partially replace blood supply from the portal venous system. The liver receives blood supply from one substitute artery and the hepatic artery. This method has been classified into the portal vein arterialization methods. This concept differs from the intrahepatic arteriovenous fistula or single blood supply of the liver due to complex reasons, such as hepatic artery injury due to resection of hilar cholangiocarcinoma [1,2,3]. Since dual hepatic arterial blood supply methods were first used in liver transplantation, they have been applied to patients such as orthotopic liver transplant recipients with extensive portal vein thrombosis and those who cannot receive liver transplantation in the short term due to acute liver failure. Traditional methods have been proven unable to improve the prognosis of such patients
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