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

本研究旨在探讨离体断奶仔猪离体肝双转流自动血泵灌注过程中门脉循环对肝细胞代谢的影响。在12只平均体重为8.8 kg的断奶约克郡猪中，通过肝静脉和门静脉之间的旁路建立了隔离肝脏灌注，持续4 h。灌注回路用自体新鲜血液预充，并在肝脏灌注期间以15 ml/h输注无葡萄糖的1/2盐水溶液。根据门静脉转流率将动物分为3组：G-10：以10 ml/min/kg的流量进行肝脏灌注; G-20：以20 ml/min/kg的流量进行肝脏灌注; G-30：以30 ml/min/kg的流量进行肝脏灌注。结果，总蛋白和白蛋白随着时间的推移而逐渐下降，并且G-20的总蛋白比G-10显著降低。血糖在肝脏灌注开始后显著升高，此后在三组中逐渐降低。在所有组中，G-10的葡萄糖值最低。相反，甘油三酯随着时间的推移逐渐增加，其增加在G-10中显著。在所有组中，总胆固醇、游离脂肪酸、磷脂和β-脂蛋白均随时间逐渐降低，但在G-20中这些降低明显。肝脏灌流开始后，脂质过氧化物即开始升高，G-20逐渐升高，且升高明显。离体肝脏灌流时，GOT、GPT、LDH等肝功能指标显示，G-10出现轻度肝功能异常，可能与肝细胞轻度缺血有关。G-30中的所有参数都不可靠，因为实验期间输血是必要的，以保持byproductflow.In结论，在隔离肝脏灌注过程中的肝脏代谢的变化被认为是在门静脉旁路流量较少的组中较轻。

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.