The Influence And Mechanism Of Hepatic Congestion After Partial Hepatectomy On Early Stage Remnant Liver Function And Regeneration In Rats

Objective:To investigate the influence and mechanism of liver congestion after partial hepatectomy on remnant liver regeneration and early stage liver function.Methods:Part I:Sixty Sprague–Dawley rats were divided into two groups randomly. non-congestion group: 70% of liver resection( mid lobe+ left lobe);congestion group:70% of liver resection( mid lobe+ left lobe)with whole caudal lobe congestion. Twenty SD rats ware used to postoperative survival analysis.the rest of rats ware sacrificed at indicate time points.Blood biochemistry were determined using Biochemical autoanalyzer. Liver tissue histopathology was determined with HE.The expression of cleaved casepase-3 and PCNA in liver tissues was investigated by Western blot.Part II:ninety Sprague–Dawley rats were divided into three groups randomly:non-congestion group: 70% of liver resection( mid lobe+ left lobe);congestion group;70% of liver resection( mid lobe+ left lobe)with whole caudal lobe congestion;congestion+splenectomy group:70% of liver resection( mid lobe+ left lobe)with whole caudal lobe congestion and splenectomy.Twenty SD rats ware used to postoperative survival analysis.the rest of rats were sacrificed at indicate time points(12h,24h) after measuring portal venous pressure,collecting blood and liver tissue sample.Blood biochemistry were determined using Biochemical autoanalyzer. Liver tissues were immunohistochemically stained for the expression of CD68 in macrophagocyte. Hyaluronic acid(HA) was measured by ELISA. The expression of ET-1, eNOS, TNF-α, IL-6 were determined by RT-PCR.The expression of cleaved casepase-3, Hif-1α in liver tissues was investigated by Western blot.Result:Part I:Two groups of rats five survival rate:non-congestion group75%,congestion group20%.At 12,24 h after surgical procedure, The blood ammonia concentration and total bilirubin level in congestion group is significantly higher than non-congestion group(P<0.05). Compare with non-congestion group, the expression of PCNA were significantly lower in the congestion group at 24 h after resection determined by Western blot. The serum ALT、AST level in congestion group were obviously higher than non-congestion group at 24 h after surgical procedure(P<0.05),At the same time, a large number of vacuoles degeneration cell was observed in non-congestion tissue of congestion group. Compare with non-congestion group, the expression of casepase-3 were significantly lower in the congestion group at 24 h after resection determined by Western blot.Part II: Three groups of rats five survival rate:non-congestion group75%,congestion group20%,congestion+splenectomy group55%. At 12, 24 h after surgical procedure, The total bilirubin level, portal venous pressure(PVP), HA,(TNF-a, IL-6, ET-1,eNOS)mRNA relative expression in congestion group is significantly higher than non-congestion group. At the same time compare with non-congestion group, a large number of vacuoles degeneration cells and more CD68 positive cells was observed in non-congestion tissue of congestion group. The expression of Cleaved casepase-3, PCNA detected by Western blot in non-congestion tissue of congestion group is lower than the expression in non-congestion group. In congestion+splenectomy group, the phenomenon mentioned above was significantly ameliorated.Conclusion:Part I:In the model of SD rat performed 70% of liver resection with whole caudal lobe congestion, liver function was further aggravating accompanied with higher mortality of rats caused by hepatic congestion though vacuoles degeneration cell and increased cell apoptosis in non-congestion tissue. At the same time, Liver regeneration was reduced.Part II: On the basis of a wide range of liver resection, a wide range of hepatic congestion caused a large number of vacuoles degeneration cells, increased cells apoptosis, aggravated damage of liver function, increased mortality of rats though hepatic microcirculation disorder, hypoxia, inflammation caused by portal hypertension.