15 August 2017 : Original article
Congestive Preconditioning by Portal Venous Clamping: A Novel Preventive Concept for Small Intestinal Congestive Re-Outflow InjuryHironori Hayashi1ABCDEFG*, Hiroyuki Takamura1ACDF, Ryosuke Gabata1BD, Yoshinao Ohbatake1BCD, Shinichi Nakanuma1BCD, Tomoharu Miyashita1CDF, Hidehiro Tajima1CDF, Itasu Ninomiya1CDF, Sachio Fushida1DFG, Tetsuo Ohta1ADFG
Ann Transplant 2017; 22:493-498
BACKGROUND: Congestion of the small intestine, which induces mucosal damage via apoptosis, is a common pathophysiological change in hepato-biliary-pancreatic surgery, including liver transplantation. Small intestinal mucosal damage can trigger postoperative complications via various pathways. Therefore, we investigated the efficacy of intermittent portal venous clamping, which we named congestive preconditioning (CPC), for decreasing congestive re-outflow injury (CRoI) of the small intestine.
MATERIAL AND METHODS: Small intestinal CRoI was induced in rats by clamping the portal vein (PV) for 30 min, followed by re-outflow. The CPC group underwent 3 episodes of 5 min PV clamping and 5 min re-outflow before CRoI. The Control group underwent CRoI after 30 min simple laparotomy without any preconditioning. Survival and histological changes in the small intestine after CRoI were analyzed. The histological changes were compared CPC group to Control group using a scoring system that expressed histopathological severity. Also, small intestinal apoptosis and expression of apoptosis-related genes were analyzed by immunohistochemistry.
RESULTS: The survival rate of the CPC group was significantly higher than Control group. Histological scoring of small intestinal damage was significantly lower in the CPC group after 6 h of CRoI. Expression of anti-apoptotic gene, Bcl-xL was significantly increased, but pro-apoptotic gene caspase-3 and apoptotic cells did not differ significantly between the CPC group and Control group.
CONCLUSIONS: Induction of CPC for small intestinal CRoI was effective, which suggests that an anti-apoptotic pathway is involved in the beneficial mechanism.
Keywords: Intestine, Small, Liver Transplantation, Splanchnic Circulation
14 Sep 2023 : Case reportIntrahepatic Venous Collateral Circulation and Reverse Blood Flow After Main Hepatic Vein Obstruction: A Ca...
Ann Transplant In Press; DOI: 10.12659/AOT.941521
12 Sep 2023 : Original articleThree-Dimensional Printing of Polycaprolactone/Nano-Hydroxyapatite Composite Scaffolds with a Pore Size of ...
Ann Transplant In Press; DOI: 10.12659/AOT.940365
04 Sep 2023 : Original articleAnalysis of Anxiety and Influencing Factors in Kidney Transplant Recipients and General Public During the C...
Ann Transplant In Press; DOI: 10.12659/AOT.941489
Most Viewed Current Articles
24 Aug 2021 : Review articleNormothermic Machine Perfusion (NMP) of the Liver – Current Status and Future Perspectives
Ann Transplant 2021; 26:e931664
26 Jan 2022 : Review articleRecurrence of Hepatocellular Carcinoma After Liver Transplantation: Risk Factors and Predictive Models
Ann Transplant 2022; 27:e934924
29 Dec 2021 : Original articleEfficacy and Safety of Tacrolimus-Based Maintenance Regimens in De Novo Kidney Transplant Recipients: A Sys...
Ann Transplant 2021; 26:e933588