Διαταραχές της λειτουργίας του εντέρου σε πειραματικό μοντέλο ισχαιμίας και επαναιμάτωσης ήπατος χοίρων μετά ηπατεκτομή: ο ρόλος της δεσφερριοξαμίνης και του βιοτεχνητού ήπατος

Abstract

Background: This study aims to evaluate whether injury of gut mucosa in a porcine model of post-hepatectomy liver dysfunction can be prevented using antioxidant treatment with desferrioxamine and bioartificial liver support. Methods: Post-hepatectomy liver failure was induced in pigs combining major (70%) liver resection and ischemia/reperfusion injury. An ischemic period of 150 minutes, was followed by reperfusion for 24 hours. Animals were randomly divided into a control group (n=6), a desferrioxamine group (DFX, n=6) and a bioartificial liver support group (Hepat, n=6). DFX animals were treated with continuous IV infusion of desferrioxamine 100 mg/kg. Hepat group animals were subjected to a 6 hour extracorporeal session with bioartificial liver, starting from 6 hours after reperfusion. Intestinal mucosal injury (IMI), bacterial and endotoxin translocation (BT) were evaluated in all animals. Intestinal mucosa was also evaluated for oxidative markers. Results: Both therapeutic groups had improvement of liver function and hepatic encephalopathy, significantly lower IMI scores, decreased BT and endotoxinaemia in the portal and systemic circulation and improved oxidative stress markers. Conclusion: Desferrioxamine as well as bioartificial liver support therapy seems to attenuate mucosal injury and bacterial translocation from post-hepatectomy liver dysfunction following major hepatectomy under vascular control.