Abstract
We studied ischemic injury of the liver and the protective effects of perfusion with a cold solution following total hepatic vascular exclusion (THVE) in a rat model, which was developed in our laboratory. Rats underwent total hepatic ischemia for 20 minutes (group A) or 45 minutes (group B) . In addition each group was further divided into two subgroups : subgroup a, ischemia alone; subgroup b, perfusion with a cold lactated Ringer's solution (4°C) . Serum levels of aspartate transaminase ( AST), alanine transaminase (ALT), and lactate dehydrogenase (LDH), as markers of hepatocellular injury, and serum hyaluronate, as an indicator of damage to endothelial cells, were measured. Liver tissue blood flow was assessed serially after reperfusion of the liver, and the histologic findings in the perfused liver were also evaluated on the 7th day after surgery. Serum levels of AST and ALT were high in the early period in group B, but after recovery there were no differences between the groups. In addition, levels of LDH in the perfusion group were significantly less than in the nonperfusion group. Both postoperative liver tissue blood flow and changes in serum levels of hyaluronate indicated a rather rapid recovery from ischemic damage in perfusion subgroup b after ischemia for 20 or 45 minutes. Histologic examination indicated that hepatocellular damage and derangement of sinusoidal structure were minimal in subgroup b. These findings suggest that perfusion with a cold solution during THVE is a beneficial procedure to protect liver tissue, although serum levels of AST, ALT, and hyaluronate were higher than in the non-perfusion groups at an early stage.
