Effects of stress and portal circulation on metabolism of the hepatocytes during isolated liver perfusion in weanling swine.

本研究旨在探讨门脉循环对断奶仔猪离体肝脏双旁路自动血泵灌注过程中肝细胞代谢的影响。在12头平均体重8.8 kg的断奶约克郡猪身上，通过肝静脉和门静脉之间的旁路，建立了4小时的孤立肝脏灌注。肝脏灌注时灌注回路灌注自体新鲜血液，以15ml /h的速度灌注无糖1/2生理盐水。按门静脉旁路流速分为3组；G-10：流量为10 ml/min/kg的肝脏灌注，G-10：流量为20 ml/min/kg的肝脏灌注，G-30：流量为30 ml/min/kg的肝脏灌注。结果表明，总蛋白和白蛋白随时间逐渐降低，G-20组总蛋白明显低于G-10组。三组小鼠肝脏灌注开始后血糖均显著升高，随后逐渐降低。G-10组葡萄糖值最低。相反，甘油三酯随着时间的延长而逐渐升高，在G-10时增幅显著。各组总胆固醇、游离脂肪酸、磷脂和β-脂蛋白随时间逐渐降低，但G-20组下降明显。脂质过氧化在肝灌注开始后立即升高，在G-20组中明显且逐渐升高。GPT、GPT、LDH检测离体肝灌注时肝功能显示G-10期出现轻度肝功能障碍，认为是肝细胞轻度缺血所致。G-30的所有参数都不可靠，因为在实验过程中需要输血以保持旁路流量。综上所述，分离肝灌注时肝脏代谢的变化被认为在门静脉旁路血流较少的组中较轻。

The present study was designed to investigate effects of portal circulation on metabolism of the hepatocytes during isolated liver perfusion with double bypass using automatic blood pumps in weanling swine. Isolated liver perfusion was established with bypass between the hepatic vein and portal vein for up to 4 hours in 12 weanling Yorkshire swine with a mean body weight of 8.8 kg. The perfusion circuit was primed with autologous fresh blood and infused with glucose-free 1/2 saline solution at 15 ml/hour during liver perfusion. The animals were divided into 3 groups by means of portal bypass flow rates; G-10 : liver perfusion at a flow rate of 10 ml/min/kg, G-20 : at a flow rate of 20 ml/min/kg, G-30 : at a flow rate of 30 ml/min/kg.As results, total protein and albumin were gradually decreased with time and total protein in G-20 decreased significantly than in G-10. Blood glucose was significantly elevated after initiation of liver perfusion, and gradually decreased thereafter in three groups. Glucose values were lowest in G-10 among all groups. On the contrary, triglyceride was gradually increased with time, and its increase was significantly marked in G-10. Total cholesterol, free fatty acid, phospholipids, and β-lipoprotein were gradually decreased with time in all groups, however, those decreases were marked in G-20. Lipid peroxide was increased immediately after initiation of liver perfusion and its elevation was marked and gradually in G-20.Liver function tests during isolated liver perfusion by means of GOT, GPT, LDH demonstrated that mild liver dysfunction occurred in G-10, which was thought to be due to mild hepatocytes ischemia. All parameters in G-30 were not reliable because transfusion during experiments was necessary in order to keep bypass flow.In conclusion, changes in hepatic metabolism during isolated liver perfusion were thought to be milder in the group with less portal bypass flow.