Advertisement
Society of University Surgeons| Volume 52, ISSUE 1, P88-102, July 1962

Liver regeneration following portacaval shunt

      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      The results of this study indicate that the liver has not lost its capacity to regenerate following portacaval shunt, and the degree of restoration is not significantly different from that observed in intact animals following partial hepatectomy. Such conclusions result from the use of shunt animals, rather than intact normal animals, as suitable controls for the assessment of regeneration. The effect upon the liver of portacaval shunt alone has thus been distinguished from that following combined shunt and partial hepatectomy.
      Considerable atrophy results from restriction of portal blood flow. Such livers are capable of restoration of hepatic mass and protein, and, as evidenced by mitotic counts and incorporation of P32 into DNA, parenchymal cells undergo division in a fashion comparable to that observed following liver resection in animals with an intact circulation. Contrary to the reports of others, it appears from these findings that portal blood, or blood per se, traversing the liver via the portal circulation, is not so much a prerequisite for hepatic restoration as it is for the inhibition of hepatic atrophy.
      Liver atrophy was slight after side-to-side shunt, as compared with that after end-to-side shunt. The degree of hepatic (and protein) restoration following partial resection was, however, similar in both groups (65 per cent and 61 per cent). Possible clinical significance of these findings is being entertained.
      No evidence was obtained to support the importance of a humoral factor in the process of liver regeneration in portacaval shunt animals. The injection of plasma from hepatectomized rats into single shunt animals and partial hepatectomy, with or without antecedent portacaval shunt in one member of a parabiotic pair, failed to disclose significant differences in the number of mitoses or DNA-P specific activity of liver compatible with the presence of such a factor.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Adibi S.
        • Paschkis K.E.
        • Cantarow A.
        Stimulation of liver mitoses by blood serum from hepatectomized rats.
        Exper. Cell Res. 1959; 18: 396
        • Bucher N.L.R.
        • Scott J.F.
        • Aub J.C.
        Regeneration of the liver in parabiotic rats.
        Cancer Res. 1951; 11: 457
        • Bunster E.
        • Meyer R.K.
        An improved method of parabiosis.
        Anat. Rec. 1933; 57: 339
        • Child III, C.G.
        The portal circulation.
        New England J. Med. 1955; 252: 837
        • Child III, C.G.
        • Barr D.
        • Holswade G.R.
        • Harrison S.C.
        Liver regeneration following portacaval transposition in dogs.
        Ann. Surg. 1953; 138: 600
        • Christensen B.F.
        • Jacobsen E.
        Studies on liver regeneration.
        Acta med. scandinav., supp. 1949; 234: 103
        • Cohn R.A.
        A skeptical evaluation of portacaval anastomosis for gastrointestinal hemorrhage in cirrhosis of the liver.
        Stanford M. Bull. 1951; 9: 23
        • Daoust R.
        • Hooper C.E.S.
        Isolation of labelled deoxyribonucleic acid phosphorus by a modified Schmidt and Thannhauser procedure.
        Canad. J. Biochem. & Physiol. 1957; 35: 721
        • Ellis D.S.
        • Linton R.R.
        • Jones C.M.
        Effect of venous-shunt surgery on liver function in patients with portal hypertension: A follow-up study of 125 patients operated on in the last 10 years.
        New England J. Med. 1956; 254: 931
        • Fisher B.
        • Russ C.
        • Updegraff H.
        • Fisher E.R.
        Effect of increased hepatic blood flow upon liver regeneration.
        A. M. A. Arch. Surg. 1954; 69: 263
        • Friedrich-Freska H.
        • Zaki F.G.
        Spezifische Mitose-Auslosung in normaler rattenleber durch serum von partiell hepatektomierten ratten.
        Ztschr. Naturforsch. 1954; 9: 394
        • Harper H.A.
        • Gardner R.E.
        • Johansen R.
        • Galente M.
        • McCorkle H.J.
        Amino acid tolerance in experimental portacaval anastomosis.
        Surgery. 1951; 29: 210
        • Higgins G.M.
        • Anderson R.M.
        Experimental pathology of the liver. I. Restoration of the liver of the white rat following partial surgical removal.
        Arch. Path. 1931; 12: 186
        • Higgins G.M.
        • Mann F.C.
        • Priestley J.T.
        Experimental pathology of the liver. X. Restoration of the liver of the domestic fowl.
        Arch. Path. 1932; 14: 491
        • Hollenbeck G.
        • Shocket E.
        An evaluation of portacaval shunts for portal hypertension.
        Surg. Gynec. & Obst. 1957; 105: 49
        • Islami A.H.
        • Pock G.T.
        • Hubbard J.C.
        The humoral factor in regeneration of the liver in parabiotic rats.
        Surg. Gynec. & Obst. 1959; 108: 599
        • Knutti R.E.
        • Erickson G.C.
        • Madden S.C.
        • Rekers P.E.
        • Whipple G.H.
        Liver function and blood plasma protein formation: Normal and Eck fistula dogs.
        J. Exper. Med. 1937; 65: 455
        • Kohn R.
        Effect of administration of rat serum on rat liver regeneration.
        Exper. Cell Res. 1958; 14: 228
        • Lee S.H.
        • Fisher B.
        Portacaval shunt in the rat.
        Surgery. 1961; 50: 668
        • MacDonald R.A.
        • Rogers A.E.
        Control of regeneration of the liver—Lack of effect of plasma from partially hepatectomized, cirrhotic and normal rats upon deoxyribonucleic acid synthesis and mitosis in rat liver.
        Gastroenterology. 1961; 41: 33
        • MacPherson A.I.S.
        • Owen J.A.
        • Innes J.
        Hepatic function after operations for portal hypertension.
        Lancet. 1954; 2: 356
        • Mann F.C.
        The portal circulation and restoration of the liver after partial removal.
        Surgery. 1940; 8: 225
        • Mann F.C.
        Restoration and pathologic reactions of the liver.
        J. Mt. Sinai Hosp. 1944; 11: 65
        • Mann F.C.
        • Fishback F.C.
        • Gay J.C.
        • Green G.F.
        Experimental pathology of the liver. III. The effect of diverting the portal blood on the restoration of the liver after partial removal.
        Arch. Path. 1931; 12: 787
        • Mann F.C.
        • Magath T.B.
        The production of chronic liver insufficiency.
        Am. J. Physiol. 1922; 59: 485
        • Mannix Jr., H.
        • Cornell G.
        • O'Sullivan W.D.
        The regeneration of the liver in the monkey and in the monkey with portacaval shunt.
        Surgery. 1956; 40: 874
        • Peskin G.W.
        • Berggren R.B.
        • Crichlow R.W.
        Evaluation of venous shunting procedures for portal hypertension.
        S. Clin. North America. 1960; 40: 1551
        • Ripstein C.B.
        Experiences with portacaval anastomosis in the treatment of portal hypertension.
        Surgery. 1953; 34: 570
        • Rogers A.E.
        • Shaka J.A.
        • Pechet G.
        • MacDonald R.A.
        Regeneration of the liver. Absence of a humoral factor affecting regeneration in parabiotic rats.
        Am. J. Path. 1961; 39: 561
        • Sedgwick C.E.
        • Hume H.A.
        Analysis of forty-two shunt procedures for portal hypertension.
        A. M. A. Arch. Surg. 1959; 78: 359
        • Silen W.
        • Mawdsley D.L.
        • Weirich W.L.
        • Harper J.A.
        Studies of hepatic function in dogs with Eck fistula or portacaval transposition.
        A. M. A. Arch. Surg. 1957; 74: 964
        • Smythe R.L.
        • Moore R.O.
        A study of possible humoral factors in liver regeneration in the rat.
        Surgery. 1958; 44: 561
        • Stephenson G.W.
        Experimental pathology of the liver. IX. Restoration of the liver following partial hepatectomy and partial ligation of the portal vein.
        Arch. Path. 1932; 14: 484
        • Stitch H.F.
        • Florian M.L.
        The presence of a mitosis inhibitor in the vein and liver of adult rats.
        Canad. J. Biochem. & Physiol. 1953; 36: 855
        • Weinbren K.
        The portal blood supply and regeneration of the rat liver.
        Brit. J. Exper. Path. 1955; 36: 583
        • Wenneker A.S.
        • Sussman N.
        Regeneration of liver tissue following partial hepatectomy in parabiotic rats.
        in: ed. 4. Proc. Soc. Exper. Biol. & Med. 76. 1951: 638
        • Whipple G.H.
        • Rolscheit-Robbins F.S.
        • Hawkins W.B.
        Eck fistula liver subnormal in producing hemoglobin and plasma proteins on diets rich in liver and iron.
        J. Exper. Med. 1945; 81: 171
        • Zimmerman M.
        • Cellozzi E.
        Stimulation of cell division in normal rat liver by a factor from hepatectomized rats.
        in: ed. 4. Fed. Proc. 19. 1960: 139