Abstract
Background
The associating liver partition and portal vein ligation for staged hepatectomy (ALPPS)
procedure promotes the proliferation of the future liver remnant, but evidence to
support the feasibility of ALPPS in livers with fibrosis is needed. Therefore the
aim of this study was to establish a fibrotic ALPPS model in the rat to compare the
capacity of regeneration in the remnant liver with or without fibrosis.
Methods
In our study we first established a thioacetamide-induced fibrotic ALPPS model in
rats. Then the ALPPS-induced regenerative capacities of normal and fibrotic liver
were compared in this animal model. In addition, markers of regeneration, including
the proliferative index and cyclin D1 and proliferating cell nuclear antigen levels,
as well as various indicators of liver function were determined to evaluate the quality
of the hepatic regeneration.
Results
Compared with that of the sham group (opening of the peritoneal cavity with no further
operative manipulation), the proliferation of the future liver remnant in fibrotic
rat liver after the ALPPS procedure was increased on postoperative days 1, 2, and
5 (P < .039 each). In addition, the proliferative response was greater in the ALPPS group
than in the ligation group subjected only to portal vein ligation of the left lateral,
left middle, right, and caudate lobes (P = .099, P = .006, and P = .020 on postoperative days 1, 2, and 5, respectively). In contrast, the ALPPS-induced
regenerative capacity in the fibrotic rat livers was attenuated compared with that
in the normal liver on postoperative days 1, 2, and 5 (P < .031 for each) after stage I and on postoperative day 5 after stage II of the ALPPS
procedure (P < .005). This attenuated the recovery of liver function, and the greater mortality
rate indicated that functional proliferation was either delayed or not as extensive
in the fibrotic rat livers.
Conclusion
Through establishing a rat model of thioacetamide-induced liver fibrosis, we found
that ALPPS-derived liver regeneration was present and feasible in fibrotic livers,
but this effect was attenuated compared with that in normal liver.
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Article info
Publication history
Published online: September 21, 2018
Accepted:
August 8,
2018
Received in revised form:
August 5,
2018
Received:
April 12,
2018
Footnotes
This study was supported by the Public Welfare Technology Application Project of Zhejiang Province (Grant No. 2017C33043, Recipient: Wang Yifan).
Identification
Copyright
© 2018 Published by Elsevier Inc.
