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Liver microcirculation after selective denervation
M E Pedrosa1, E F Montero, A J Nigro
1Operative Technique and Experimental Surgery Division, Department of Surgery, Universidade Federal de São Paulo-Escola Paulista de Medicina, São Paulo, Brazil.
Abstract:
Microcirculatory disturbances have been related to a decrease in survival after liver transplant. Because innervation is involved in liver hemodynamics regulation, we decided to evaluate microcirculatory hepatic perfusion. Thirty rats were divided into three groups: denervated (DG), hepatic microsurgical denervation; manipulated (MG), hepatic manipulation; control (CG), laparotomy. Hepatic microcirculation was assessed in the median lobe using laser Doppler flowmetry in the following moments: T(0), after laparotomy and T(1), after denervation; and in the following moments after denervation: T(2), 10 minutes, T(3), 20 minutes, T(4), 30 minutes, T(5), 1 hour, T(6), 1.5 hours, and T(7), 2 hours for DG, and in same moments for MG and CG. DG showed a decrease in hepatic perfusion for 20 minutes after denervation, different from MG and CG. After that, there was recovery in hepatic perfusion in MG and DG (Kruskal-Wallis and Friedman tests). Therefore, denervation and manipulation alter hepatic microcirculation, but denervation promotes a more severe decrease than manipulation.
Insights
Liver denervation and manipulation temporarily reduce hepatic microcirculation. Denervation causes a more significant, though transient, decrease in liver blood flow compared to simple manipulation.
Area of Science:
- Hepatology
- Transplantation Surgery
- Microcirculation Research
Background:
- Microcirculatory disturbances are linked to reduced survival rates following liver transplantation.
- Liver innervation plays a crucial role in regulating hepatic hemodynamics.
Purpose of the Study:
- To investigate the impact of hepatic denervation and manipulation on microcirculatory hepatic perfusion.
- To compare the effects of denervation versus mere manipulation on liver blood flow.
Main Methods:
- Thirty rats were allocated into three groups: denervated (DG), manipulated (MG), and control (CG).
- Hepatic microcirculation in the median lobe was assessed using laser Doppler flowmetry at multiple time points post-procedure.
- Measurements were taken immediately after laparotomy and at intervals up to 2 hours after denervation/manipulation.
Main Results:
- The denervated group (DG) exhibited a significant decrease in hepatic perfusion for 20 minutes post-denervation, unlike the manipulated (MG) and control (CG) groups.
- Hepatic perfusion recovered in both DG and MG groups after the initial period.
- Denervation resulted in a more pronounced reduction in hepatic microcirculation than hepatic manipulation.
Conclusions:
- Both hepatic denervation and manipulation transiently alter liver microcirculation.
- Hepatic denervation leads to a more severe, albeit temporary, impairment of hepatic perfusion compared to surgical manipulation alone.