Efficacy of Platelet-rich Fibrin on Bile Duct Anastomosis in a Rat

Abstract

Objectives The bile duct and the vascular endothelium are vulnerable to damaging effects of ischemic, immunologic, and preservation injuries. Therefore, biliary complications following liver transplantation are common and remain a major source of morbidity in liver transplant patients. Platelet-rich-fibrin (PRF) is a safe, autologuos and degredable material which contain high amount of plateletes and fibrin. Aim of the study was to evaluate the effect of PRF on bile duct anastomosis healing process in rats. Methods Thirty male Sprague Dawley (SD) rats were used for the study. The animals were allocated into three groups: Group I Control group(n=10): Anastomosis to common bile duct (CBD) over a stent. Group II PRF Group(n=10): Anastomosis to CBD over a stent and covered with PRF. Group III Sham Group(n=10):Preparation of common bile duct, no anastomosis. The animals were followed up for 1 month, then sacrificed. Study parameters were adhesions around the anastomosis, bridging bile duct tissue thickness over the stent and histopathologic examination of the bridging bile duct tissue. Results CBD anastomosis over a stend caused severe adhesion around the anastomosis, bridging bile duct tissues were weak and histopathologically healing were incomplet in most of the control animals. PRF application however, significantly reduced the adhesions, increased the quality of bridging bile duct tissues and caused complete healing histologically. Conclusion PRF is a safe, autologuos, easily prepared membrane. Our findings shows that PRF prevents local complications, and increases healing capacity of the bile duct after CBD anastomosis. Therefore it might be an alternative treatment option to prevent bile duct complications after liver transplantation patients.