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Haemodynamic changes in ischaemic vs. anhepatic pig experimental model of acute liver failure

Published online by Cambridge University Press:  16 August 2006

K. Theodoraki ,
G. Kostopanagiotou ,
V. Smyrniotis ,
N. Arkadopoulos ,
A. Prachalias ,
N. Pyrsopoulos  and
J. Papadimitriou
K. Theodoraki
Affiliation:
Areteion Hospital, Experimental Laboratory of the 2nd Department of Surgery, University of Athens, Greece
G. Kostopanagiotou
Affiliation:
Areteion Hospital, Experimental Laboratory of the 2nd Department of Surgery, University of Athens, Greece
V. Smyrniotis
Affiliation:
Areteion Hospital, Experimental Laboratory of the 2nd Department of Surgery, University of Athens, Greece
N. Arkadopoulos
Affiliation:
Areteion Hospital, Experimental Laboratory of the 2nd Department of Surgery, University of Athens, Greece
A. Prachalias
Affiliation:
Areteion Hospital, Experimental Laboratory of the 2nd Department of Surgery, University of Athens, Greece
N. Pyrsopoulos
Affiliation:
Areteion Hospital, Experimental Laboratory of the 2nd Department of Surgery, University of Athens, Greece
J. Papadimitriou
Affiliation:
Areteion Hospital, Experimental Laboratory of the 2nd Department of Surgery, University of Athens, Greece
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Abstract

Background and objective: The removal of the non-functioning liver in cases of fulminant liver failure has been advocated by some authors as a means of improving haemodynamic instability and acid-base disturbances associated with acute liver failure.

Methods: The aim of the present experimental study was to investigate whether maintaining a non-functioning liver is preferable over removing it in terms of haemodynamic variables, after acute hepatic failure has been surgically induced. Twenty Landrace pigs were used in the study. All of them underwent portocaval anastomosis and ligation of the hepatic artery. After an 18-h period and with biochemical indices of fulminant hepatic failure clearly demonstrated, the animals were randomly assigned to one of two groups: in 10 pigs (Group A) the ischaemic liver was left in situ and no further surgical intervention was undertaken. The other 10 (Group B) underwent total hepatectomy. Haemodynamic monitoring was the same in both groups. No inotropes were administered throughout the whole period of observation.

Results: Haemodynamic deterioration was observed in the hepatectomized pigs (Group B) whereas the group with the ischaemic liver in situ (Group A) remained stable in terms of the haemodynamic variables evaluated until the end of the experiment. (Cardiac index in Group A 7.59 ± 1.25 Lmin−1 m-2 vs. 2.92 ± 0.68 Lmin−1 m−2 in Group B, P < 0.05.)

Conclusions: The concept of salvage hepatectomy in cases of acute liver failure should be redefined since there seems to be some experimental evidence that it may not be as beneficial as originally thought.

Keywords

surgical proceduresoperativeliver transplantationhepatectomyliver diseasesliver failurehaemodynamicscardiac outputmodelsanimal
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 19 , Issue 1 , January 2002 , pp. 40 - 46
Copyright
2002 European Society of Anaesthesiology

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