Biochemical and electron-microscopic studies on metabolism of the hepatocytes and body during isolated liver perfusion in weanling swine.

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The present study was designed to investigate metabolic changes in the liver during isolated liver perfusion with double bypass using automatic blood pumps. Isolated liver perfusion was established with bypass between, the hepatic vein and portal vein in 15 weanling Yorkshire swine weighing 8.0 to 12.1 kg with a mean body weight of 9.9 kg, at a flow rate of 20 ml/mm/kg for up to 4 hours. The perfusion circuit was infused with glucose-free 1/2 saline solution at 15 ml/hour, and insulin or glucagon were added. The animals were divided into 5 groups by means of contents of perfusate ; CONT : liver perfusion with perfusate without hormone, 25RI : containing 25 units of regular insulin in 500 ml of perfusate, 75RI : containing 75 units of regular insulin in 500 ml of perfusate, 25GL : containing 0.25 mg of glucagon in 15 ml of perfusate, and 50GL : containing 0.5 mg of glucagon in 15 ml of perfusate.As a result, total protein, albumin, and total cholesterol were gradually decreased with time and there were no differences between the groups. On the contrary, triglyceride was gradually increased with time, and its increase was marked in groups with perfusate containing insulin. Blood glucose was significantly elevated after initiation of liver perfusion, and kept constant thereafter in CONT and glucagons groups. Its elevation was higher in groups with glucagons than in the CONT group. Blood glucose after 2 hours of perfusion was gradually and significantly decreased in groups perfused with perfusate containing insulin. Its decrease was more marked in the 75RI group than in 25 RI group. Insulin influences the hepatic metabolism during isolated perfusion in dose-response manner.We also investigated Iinterleukin-6 (IL-6) and Tumor Necrosis Factor-α (TINE-α) during liver perfusion, and TNF-α, which was thought to be the cause of hyperglycemia, was kept within normal limits during liver perfusion.