Porcine model for the study of liver regeneration enhanced by non-invasive 13C-methacetin breath test (LiMAx test) and permanent portal venous access.

Autor: Wittauer EM; ReMediES, Department of General, Visceral and Transplant Surgery, Hannover Medical School, Hannover, Germany., Oldhafer F; ReMediES, Department of General, Visceral and Transplant Surgery, Hannover Medical School, Hannover, Germany., Augstein E; ReMediES, Department of General, Visceral and Transplant Surgery, Hannover Medical School, Hannover, Germany., Beetz O; ReMediES, Department of General, Visceral and Transplant Surgery, Hannover Medical School, Hannover, Germany., Kleine M; ReMediES, Department of General, Visceral and Transplant Surgery, Hannover Medical School, Hannover, Germany., Schumacher C; Department of Anaesthesiology and Intensive Care Medicine, Hannover Medical School, Hannover, Germany., Sieg L; Department of Anaesthesiology and Intensive Care Medicine, Hannover Medical School, Hannover, Germany., Eismann H; Department of Anaesthesiology and Intensive Care Medicine, Hannover Medical School, Hannover, Germany., Johanning K; Department of Anaesthesiology and Intensive Care Medicine, Hannover Medical School, Hannover, Germany., Bleich A; Institute for Laboratory Animal Science, Hannover Medical School, Hannover, Germany., Vondran FWR; ReMediES, Department of General, Visceral and Transplant Surgery, Hannover Medical School, Hannover, Germany.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2019 May 31; Vol. 14 (5), pp. e0217488. Date of Electronic Publication: 2019 May 31 (Print Publication: 2019).
DOI: 10.1371/journal.pone.0217488
Abstrakt: Introduction: Despite advances in perioperative management and surgical technique, postoperative liver failure remains a feared complication after hepatic resection. Various supportive treatment options are under current discussion, but lack of structured evaluation. We therefore established a porcine model of major liver resection to study regeneration after partial hepatectomy in a reliable and well-defined pre-clinical setting.
Methods: Major hepatectomy was performed on seven minipigs with the intention to set up a non-lethal but relevant transient impairment of liver function. For steady postoperative vascular access (e.g. for blood withdrawal, measurement of venous pressure), permanent catheters were implanted into the internal jugular and portal veins, respectively. Animals were followed up for 30 days; clinical and laboratory results were recorded in detail. Monitoring was enhanced by non-invasive determination of the maximum liver function capacity (LiMAx test).
Results and Conclusions: The established porcine model appeared suitable for evaluation of postoperative liver regeneration. Clinical characteristics and progression of liver function impairment as well as subsequent recovery were comparable to courses known from surgery in humans. Laboratory parameters (e.g. liver enzymes, bilirubin, INR, coagulation factor II) showed relevant derangements during postoperative days (POD) 0 to 3 followed by normalization until POD 7. Application of the LiMAx test was feasible in minipigs, again showing values comparable to humans and kinetics in line with obtained laboratory parameters. The exteriorized portal vein catheters enabled intra- and postoperative monitoring of portal venous pressures as well as easy access for blood withdrawal without relevant risk of postoperative complications.
Competing Interests: The authors have declared that no competing interests exist.
Databáze: MEDLINE
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