%0 Journal Article
%A Orue-Echebarria, Maitane 
%A Vaquero Martín, Francisco Javier
%A Lisbona, Cristina 
%A Lozano, Pablo
%A Steiner, Miguel 
%A Morales, Álvaro
%A López Baena, José Ángel
%A Laso, Juan
%A Hernández, Inmaculada
%A Olmedilla, Luis
%A García Sabrido, José Luis
%A Peligros Gómez, María Isabel
%A Sola Vendrell, Emma
%A Fernández Carballal, Carlos
%A Vara Ameigeiras, Elena María
%A Asencio Pascual, José Manuel
%T Comprehensive Characterization of a Porcine Model of The “Small-for-Flow” Syndrome
%D 2019
%@ 1091-255X
%U https://hdl.handle.net/20.500.14352/100471
%X MethodsWe performed subtotal (90%) hepatectomies in 10 female MiniPigs using a simplified transection technique with a tourniquet. Blood tests, hepatic and systemic hemodynamics, and hepatic function and histology were assessed before (Bas), 15 min (t-15 min) and 24 h (t-24 h) after the operation. Some pigs underwent computed tomography (CT) scans for hepatic volumetry (n = 4) and intracranial pressure (ICP) monitoring (n = 3). Postoperative care was performed in an intensive care unit environment.ResultsAll hepatectomies were successfully performed, and hepatic volumetry confirmed liver remnant volumes of 9.2% [6.2–11.2]. The hepatectomy resulted in characteristic hepatic hemodynamic alterations, including portal hyperperfusion, relative decrease of hepatic arterial blood flow, and increased portal pressure (PP) and portal-systemic pressure gradient. The model reproduced major diagnostic features including the development of cholestasis, coagulopathy, encephalopathy with increased ICP, ascites, and renal failure, hyperdynamic circulation, and hyperlactatemia. Two animals (20%) died before t-24 h. Histological liver damage was observed at t-15 min and at t-24 h. The degree of histological damage at t-24 h correlated with intraoperative PP (r = 0.689, p = 0.028), hepatic arterial blood flow (r = 0.655, p = 0.040), and hepatic arterial pulsatility index (r = 0.724, p = 0.066). All animals with intraoperative PP > 20 mmHg presented liver damage at t-24 h.ConclusionThe present 90% hepatectomy porcine experimental model is a feasible and reproducible model for investigating the “Small-for-Flow” syndrome.
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