Effects of liver denervation on hepatic microcirculation

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Hepatic artery thrombosis is a catastrophic event in patients who have undergone Liver transplantation or hepatic resection in combination with reconstruction of the hepatic artery. The only hope for salvation of the liver is prompt surgical intervention with declotting and repair, but its prognosis is still not full of hope. Recently, laparoscopic omental patch repair has been performed in the perforated duodenal ulcer, precipitating a vascular source for the injured lesion by the omentum. We performed an experimental study to evaluate the formation of new blood-vessels after omental implantation (OI) in rats with ligation of the heatic artery.Material and Methods Wistar rats (200-220g) were used for the study and divided into the following groups. Groups A : simple laparotomy as control, B : hepatic artery ligation (HAL), C : OI with HAL, D : OI without HAL.For angiography, measurements of liver tissue blood flow by Laser Doppler method, and hepatic artery flow by colored-microsphere method (CMS), and immunohistochemical study for CD34, the animals were sacrificed at 1, 3, 7, 30, 90 days after the laparotomy.Results Liver tissue blood flow (LTB) decreased significantly from 27.5*5.5 ml/min/100g to 23.5*4.5 after HAL but no siginificant increase in LTB was seen after OI.However, hepatic artery blood flow assessed by CMS in the implanted lobe of group C showed siginificantly higher levels at various times than those of group B.Angiography and microscopic studies in the excised liver revealed distinct angiogenesis around omental implantation over 7 days postoperatively.Conclusion The formation of new blood-vessels after OI was observed in rat livers with HAL.OI would be useful in the prevention of organ anoxia after hepatic artery thrombosis.