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oai:docta.ucm.es:20.500.14352/1004712025-03-18T14:25:08Zcom_20.500.14352_14col_20.500.14352_15

Comprehensive Characterization of a Porcine Model of The “Small-for-Flow” Syndrome Orue-Echebarria, Maitane Vaquero Martín, Francisco Javier Lisbona, Cristina Lozano, Pablo Steiner, Miguel Morales, Álvaro López Baena, José Ángel Laso, Juan Hernández, Inmaculada Olmedilla, Luis García Sabrido, José Luis Peligros Gómez, María Isabel Sola Vendrell, Emma Fernández Carballal, Carlos Vara Ameigeiras, Elena María Asencio Pascual, José Manuel 61 Small-for-Size Hepatectomy Pig Small-For-Flow Posthepatectomy liver failure Cirugía 3213 Cirugía Methods We 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. Results All 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. Conclusion The present 90% hepatectomy porcine experimental model is a feasible and reproducible model for investigating the “Small-for-Flow” syndrome. Sociedad Española de Trasplante Hepático Instituto de Salud Carlos III Depto. de Farmacología y Toxicología Fac. de Veterinaria TRUE pub 2024-02-08T13:31:08Z 2024-02-08T13:31:08Z 2019 journal article VoR https://hdl.handle.net/20.500.14352/100471 1091-255X 10.1007/s11605-019-04130-2 eng PI15/1083 Maitane I. Orue-Echebarria, Javier Vaquero, Cristina J. Lisbona, Pablo Lozano, Miguel A. Steiner, Álvaro Morales, José Á. López-Baena, Juan Laso, Inmaculada Hernández, Luis Olmedilla, José L. García Sabrido, Isabel Peligros, Emma Sola, Carlos Carballal, Elena Vara, J.M. Asencio, Comprehensive Characterization of a Porcine Model of The “Small-for-Flow” Syndrome, Journal of Gastrointestinal Surgery, Volume 23, Issue 11, 2019, Pages 2174-2183, Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ restricted access application/pdf Elsevier