Evaluation of selective liver denervation methods.

Main Methods:

• Four denervation techniques were employed: orthotopic liver transplantation, phenol application to the portal vein, microsurgical denervation, and intraportal 6-hydroxydopamine (6-HODA) injections.
• Liver tissue norepinephrine (NE) content was measured at 1, 4, and 8 weeks post-procedure.
• Mean arterial pressure (MAP) responses to hepatic nerve stimulation were recorded to assess functional reinnervation.

Main Results:

• Orthotopic liver transplantation, phenol application, and microsurgical denervation resulted in significantly reduced liver NE content compared to controls, with varying degrees of reinnervation observed over 8 weeks.
• 6-HODA administration showed dose-dependent effects on NE depletion, with higher doses leading to more profound initial depletion but also demonstrating some reinnervation.
• A direct correlation was observed between NE levels and the MAP increase following nerve stimulation, indicating that even partial reinnervation restores some physiological function.

Conclusions:

• The choice of hepatic denervation technique significantly influences the rate and extent of liver reinnervation.
• Functional recovery, as evidenced by blood pressure regulation, is directly linked to the degree of norepinephrine repletion in the liver.
• These findings provide critical insights into the long-term consequences of hepatic denervation and inform the selection of appropriate surgical or pharmacological strategies.