Arterialization of the portal vein improves hepatic microcirculation and tissue oxygenation in experimental cirrhosis

Abstract

Abstract Background Arterialization of the portal vein (APV) has shown beneficial effects on liver regeneration and function in selected patients undergoing liver resection and transplantation. Whether APV improves liver perfusion and function in cirrhosis is unclear. This study investigated the effect of APV on hepatic haemodynamics and liver function in a rat model of cirrhosis. Methods Male Sprague–Dawley rats (250–300 g) were divided into three groups: normal controls (n = 7), cirrhosis with sham laparotomy (sham; n = 7) and cirrhosis with APV (APV; n = 9). Portal venous blood flow, portal vein pressure and hepatic parenchymal microcirculation (HPM) were measured before and after APV. Hepatic parenchymal oxygenation was assessed by near-infrared spectroscopy and hepatocellular injury by standard liver function tests. Measurements were taken at baseline, after APV and 7 days after surgery. Results APV increased portal blood flow and pressure in cirrhotic rats without altering intrahepatic portal resistance. APV increased the HPM in cirrhotic rats by a mean(s.e.m.) of 28·5(0·1) per cent on day 0 and 54·6(0·1) per cent by day 7 (P = 0·001). Liver tissue oxygenation was increased by APV and the plasma γ-glutamyltranspeptidase level was reduced (mean(s.e.m.) 6·0(0·5) versus 3·8(0·3) units/l before and after APV respectively; P = 0·006) at day 7. Conclusion APV increases portal blood flow, tissue perfusion and oxygenation in cirrhosis.