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Multiple-system organ damage resulting from prolonged hepatic inflow interruption

D L Liu1, B Jeppsson, C H Hakansson

  • 1Department of Surgery, Lund University, Sweden.

Archives of Surgery (Chicago, Ill. : 1960)
|April 1, 1996
PubMed
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Extended hepatic inflow interruption beyond 90 minutes in rats caused liver, lung, heart, and gut damage. This suggests prolonged interruption may be hazardous in humans, potentially leading to multiple-system organ failure.

Area of Science:

  • Hepatobiliary Surgery
  • Transplantation Surgery
  • Surgical Research

Background:

  • Major hepatectomy patients previously tolerated up to 127 minutes of hepatic inflow interruption.
  • The safety and feasibility of interruptions exceeding 90 minutes remain questionable.
  • Extended interruption may cause extrahepatic multiple-system organ damage.

Purpose of the Study:

  • To investigate the safety and feasibility of continuous hepatic inflow interruption beyond 90 minutes.
  • To evaluate the potential for extrahepatic multiple-system organ damage from extended hepatic inflow interruption.

Main Methods:

  • Fifty Sprague-Dawley rats were divided into control, 90-minute, and 120-minute interruption groups.
  • Scanning electron microscopy and transmission electron microscopy were used to assess organ ultrastructure.

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  • Animal survival and multiple-system organ failure manifestations were monitored.

    • Main Results:

    • Both 90- and 120-minute interruptions led to liver cell necrosis, fibrin exudation, and severe hepatic sinusoid/nerve injury.
    • Pulmonary structures showed destruction and microcirculation breakdown.
    • Intestinal and cardiac tissues exhibited significant ultrastructural damage, including cell necrosis and vascular changes.

    Conclusions:

    • Extended continuous hepatic inflow interruption (90-120 minutes) caused significant injury to the liver, lung, heart, and gut in rats.
    • This interruption may lead to a new, unrecognized disorder of multiple-system organ failure with a high mortality rate.
    • Continuous hepatic inflow interruption exceeding 90 minutes is potentially hazardous in humans.