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Zhang W, Huang C, Yin T, Miao X, Deng H, Zheng R, Ren J, Chen S. Ultrasensitive US Microvessel Imaging of Hepatic Microcirculation in the Cirrhotic Rat Liver. Radiology 2022; 307:e220739. [PMID: 36413130 DOI: 10.1148/radiol.220739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background Liver microcirculation dysfunction plays a vital role in the occurrence and development of liver diseases, and thus, there is a clinical need for in vivo, noninvasive, and quantitative evaluation of liver microcirculation. Purpose To evaluate the feasibility of ultrasensitive US microvessel imaging (UMI) in the visualization and quantification of hepatic microvessels in healthy and cirrhotic rats. Materials and Methods In vivo studies were performed to image hepatic microvasculature by means of laparotomy in Sprague-Dawley rats (five cirrhotic and five control rats). In vivo conventional power Doppler US and ex vivo micro-CT were performed for comparison. UMI-based quantifications of perfusion, tortuosity, and integrity of microvessels were compared between the control and cirrhotic groups by using the Wilcoxon test. Spearman correlations between quantification parameters and pathologic fibrosis, perfusion function, and hepatic hypoxia were evaluated. Results UMI helped detect minute vessels below the liver capsule, as compared with conventional power Doppler US and micro-CT. With use of UMI, lower perfusion indicated by vessel density (median, 22% [IQR, 20%-28%] vs 41% [IQR, 37%-46%]; P = .008) and fractional moving blood volume (FMBV) (median, 6.4% [IQR, 4.8%-8.6%] vs 13% [IQR, 12%-14%]; P = .008) and higher tortuosity indicated by the sum of angles metric (SOAM) (median, 3.0 [IQR, 2.9-3.0] vs 2.7 [IQR, 2.6-2.9]; P = .008) were demonstrated in the cirrhotic rat group compared with the control group. Vessel density (r = 0.85, P = .003), FMBV (r = 0.86, P = .002), and median SOAM (r = -0.83, P = .003) showed strong correlations with pathologically derived vessel density labeled with dextran. Vessel density (r = -0.81, P = .005) and median SOAM (r = 0.87, P = .001) also showed strong correlations with hepatic tissue hypoxia. Conclusion Contrast-free ultrasensitive US microvessel imaging provided noninvasive in vivo imaging and quantification of hepatic microvessels in cirrhotic rat liver. © RSNA, 2022 Supplemental material is available for this article. See also the editorial by Fetzer in this issue.
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Affiliation(s)
- Wei Zhang
- From the Department of Ultrasound, Laboratory of Novel Optoacoustic (Ultrasonic) Imaging, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Rd, Guangzhou 510630, China (W.Z., T.Y., X.M., H.D., R.Z., J.R.); and Department of Radiology, Mayo Clinic College of Medicine and Science, Rochester, Minn (C.H., S.C.)
| | - Chengwu Huang
- From the Department of Ultrasound, Laboratory of Novel Optoacoustic (Ultrasonic) Imaging, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Rd, Guangzhou 510630, China (W.Z., T.Y., X.M., H.D., R.Z., J.R.); and Department of Radiology, Mayo Clinic College of Medicine and Science, Rochester, Minn (C.H., S.C.)
| | - Tinghui Yin
- From the Department of Ultrasound, Laboratory of Novel Optoacoustic (Ultrasonic) Imaging, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Rd, Guangzhou 510630, China (W.Z., T.Y., X.M., H.D., R.Z., J.R.); and Department of Radiology, Mayo Clinic College of Medicine and Science, Rochester, Minn (C.H., S.C.)
| | - Xiaoyan Miao
- From the Department of Ultrasound, Laboratory of Novel Optoacoustic (Ultrasonic) Imaging, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Rd, Guangzhou 510630, China (W.Z., T.Y., X.M., H.D., R.Z., J.R.); and Department of Radiology, Mayo Clinic College of Medicine and Science, Rochester, Minn (C.H., S.C.)
| | - Huan Deng
- From the Department of Ultrasound, Laboratory of Novel Optoacoustic (Ultrasonic) Imaging, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Rd, Guangzhou 510630, China (W.Z., T.Y., X.M., H.D., R.Z., J.R.); and Department of Radiology, Mayo Clinic College of Medicine and Science, Rochester, Minn (C.H., S.C.)
| | - Rongqin Zheng
- From the Department of Ultrasound, Laboratory of Novel Optoacoustic (Ultrasonic) Imaging, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Rd, Guangzhou 510630, China (W.Z., T.Y., X.M., H.D., R.Z., J.R.); and Department of Radiology, Mayo Clinic College of Medicine and Science, Rochester, Minn (C.H., S.C.)
| | - Jie Ren
- From the Department of Ultrasound, Laboratory of Novel Optoacoustic (Ultrasonic) Imaging, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Rd, Guangzhou 510630, China (W.Z., T.Y., X.M., H.D., R.Z., J.R.); and Department of Radiology, Mayo Clinic College of Medicine and Science, Rochester, Minn (C.H., S.C.)
| | - Shigao Chen
- From the Department of Ultrasound, Laboratory of Novel Optoacoustic (Ultrasonic) Imaging, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Rd, Guangzhou 510630, China (W.Z., T.Y., X.M., H.D., R.Z., J.R.); and Department of Radiology, Mayo Clinic College of Medicine and Science, Rochester, Minn (C.H., S.C.)
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Yang W, Chen Q, Xia R, Zhang Y, Shuai L, Lai J, You X, Jiang Y, Bie P, Zhang L, Zhang H, Bai L. A novel bioscaffold with naturally-occurring extracellular matrix promotes hepatocyte survival and vessel patency in mouse models of heterologous transplantation. Biomaterials 2018; 177:52-66. [PMID: 29885586 DOI: 10.1016/j.biomaterials.2018.05.026] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 05/14/2018] [Accepted: 05/16/2018] [Indexed: 01/26/2023]
Abstract
BACKGROUND Naïve decellularized liver scaffold (nDLS)-based tissue engineering has been impaired by the lack of a suitable extracellular matrix (ECM) to provide "active micro-environmental" support. AIM The present study aimed to examine whether a novel, regenerative DLS (rDLS) with an active ECM improves primary hepatocyte survival and prevents thrombosis. METHODS rDLS was obtained from a 30-55% partial hepatectomy that was maintained in vivo for 3-5 days and then perfused with detergent in vitro. Compared to nDLS generated from normal livers, rDLS possesses bioactive molecules due to the regenerative period in vivo. Primary mouse hepatocyte survival was evaluated by staining for Ki-67 and Trypan blue exclusion. Thrombosis was assessed by immunohistochemistry and ex vivo diluted whole-blood perfusion. Hemocompatibility was determined by near-infrared laser-Doppler flowmetry and heterotopic transplantation. RESULTS After recellularization, rDLS contained more Ki-67-positive primary hepatocytes than nDLS. rDLS had a higher oxygen saturation and blood flow velocity and a lower expression of integrin αIIb and α4 than nDLS. Tumor necrosis factor-α, hepatocyte growth factor, interleukin-10, interleukin-6 and interleukin-1β were highly expressed throughout the rDLS, whereas expression of collagen-I, collagen-IV and thrombopoietin were lower in rDLS than in nDLS. Improved blood vessel patency was observed in rDLS both in vitro and in vivo. The results in mice were confirmed in large animals (pigs). CONCLUSION rDLS is an effective DLS with an "active microenvironment" that supports primary hepatocyte survival and promotes blood vessel patency. This is the first study to demonstrate a rDLS with a blood microvessel network that promotes hepatocyte survival and resists thrombosis.
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Affiliation(s)
- Wei Yang
- Key Laboratory of Freshwater Fish Reproduction and Development, Ministry of Education, Laboratory of Molecular Developmental Biology, School of Life Sciences, Southwest University, Beibei, 400715 Chongqing, China; Hepatobiliary Institute, Southwest Hospital, The Army Medical University, Chongqing 400038, China
| | - Quanyu Chen
- Key Laboratory of Freshwater Fish Reproduction and Development, Ministry of Education, Laboratory of Molecular Developmental Biology, School of Life Sciences, Southwest University, Beibei, 400715 Chongqing, China; Hepatobiliary Institute, Southwest Hospital, The Army Medical University, Chongqing 400038, China
| | - Renpei Xia
- Hepatobiliary Institute, Southwest Hospital, The Army Medical University, Chongqing 400038, China
| | - Yujun Zhang
- Hepatobiliary Institute, Southwest Hospital, The Army Medical University, Chongqing 400038, China
| | - Ling Shuai
- Hepatobiliary Institute, Southwest Hospital, The Army Medical University, Chongqing 400038, China
| | - Jiejuan Lai
- Hepatobiliary Institute, Southwest Hospital, The Army Medical University, Chongqing 400038, China
| | - Xiaolin You
- Hepatobiliary Institute, Southwest Hospital, The Army Medical University, Chongqing 400038, China
| | - Yan Jiang
- Hepatobiliary Institute, Southwest Hospital, The Army Medical University, Chongqing 400038, China
| | - Ping Bie
- Hepatobiliary Institute, Southwest Hospital, The Army Medical University, Chongqing 400038, China
| | - Leida Zhang
- Hepatobiliary Institute, Southwest Hospital, The Army Medical University, Chongqing 400038, China.
| | - Hongyu Zhang
- Hepatobiliary Institute, Southwest Hospital, The Army Medical University, Chongqing 400038, China.
| | - Lianhua Bai
- Key Laboratory of Freshwater Fish Reproduction and Development, Ministry of Education, Laboratory of Molecular Developmental Biology, School of Life Sciences, Southwest University, Beibei, 400715 Chongqing, China; Hepatobiliary Institute, Southwest Hospital, The Army Medical University, Chongqing 400038, China.
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Fernández-Rodríguez OM, Ríos A, Palenciano C, Ramírez P, Navarro JL, Martínez-Alarcón L, Martínez C, Fuente T, Pons JA, Navarro JA, Majado M, Martínez P, Parrilla P. A hemodynamic, metabolic and histopathological study of a heterotopic auxiliary swine liver graft with portal vein arterialization. Cir Esp 2015; 94:77-85. [PMID: 26615737 DOI: 10.1016/j.ciresp.2015.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 09/18/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND Auxiliary heterotopic liver transplantation with portal vein arterialization (AHLT-PVA) is a model that has been hardly studied, despite its therapeutic potential. METHODS Hemodynamic and biochemical characterization was carried out during graft implantation, in a pig-to-pig model (n=15 AHLT-PVA). Furthermore a histopathological study was performed to establish microscopic alterations due to PVA. RESULTS Reperfusion of the arterialized graft produced an increase in heart rate (HR) vs. baseline (P=.004) and vs. inferior vena cava clamping phase (P=.004); and a decrease in systemic vascular resistance vs. cava clamping phase (P=.021). At the end of implantation, cardiac output remained elevated (P=.001), likewise HR remained increased vs. baseline phase (P=.002). Mean arterial pressure decreased with cava clamping, but was not affected by the reperfusion of the graft, nor the skin closure. The histopathological study at 3, 10, and 21 days post-PVA revealed that functional liver structure was maintained although it is common to find foci of perilobular necrosis on day 3 (P=.049), and perilobular connective tissue proliferation at day 10 (P=.007), vs. native liver. CONCLUSIONS The described arterialized liver graft model minimizes the number of vascular anastomoses vs. previously described models. It is hemodynamically and metabolically well tolerated and the double arterial vascularization of the graft does not cause significant changes in liver histology.
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Affiliation(s)
- Olga M Fernández-Rodríguez
- Departamento de Cirugía, Cirugía Experimental, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | - Antonio Ríos
- Departamento de Cirugía, Cirugía Experimental, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España; Departamento de Cirugía, Unidad de Trasplante Hepático, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España.
| | - Carlos Palenciano
- Departamento de Cirugía, Cirugía Experimental, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España; Departamento de Anestesia, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | - Pablo Ramírez
- Departamento de Cirugía, Cirugía Experimental, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España; Departamento de Cirugía, Unidad de Trasplante Hepático, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | - José Luis Navarro
- Departamento de Medicina Nuclear, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | - Laura Martínez-Alarcón
- Departamento de Cirugía, Cirugía Experimental, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | - Carlos Martínez
- Departamento de Patología, Facultad de Veterinaria, Universidad de Murcia, España
| | - Teodomiro Fuente
- Departamento de Medicina Nuclear, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | - José Antonio Pons
- Departamento de Medicina Interna, Unidad de Trasplante Hepático, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | - José Antonio Navarro
- Departamento de Patología, Facultad de Veterinaria, Universidad de Murcia, España
| | - Maruja Majado
- Departamento de Hematología, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | - Pedro Martínez
- Departamento de Hematología, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | - Pascual Parrilla
- Departamento de Cirugía, Cirugía Experimental, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España; Departamento de Cirugía, Unidad de Trasplante Hepático, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
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Schleimer K, Kalder J, Grommes J, Jalaie H, Tawadros S, Greiner A, Jacobs M, Kokozidou M. Heterotopic auxiliary rat liver transplantation with flow-regulated portal vein arterialization in acute hepatic failure. J Vis Exp 2014:51115. [PMID: 25285729 DOI: 10.3791/51115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
In acute hepatic failure auxiliary liver transplantation is an interesting alternative approach. The aim is to provide a temporary support until the failing native liver has regenerated.(1-3) The APOLT-method, the orthotopic implantation of auxiliary segments- averts most of the technical problems. However this method necessitates extensive resections of both the native liver and the graft.(4) In 1998, Erhard developed the heterotopic auxiliary liver transplantation (HALT) utilizing portal vein arterialization (PVA) (Figure 1). This technique showed promising initial clinical results.(5-6) We developed a HALT-technique with flow-regulated PVA in the rat to examine the influence of flow-regulated PVA on graft morphology and function (Figure 2). A liver graft reduced to 30 % of its original size, was heterotopically implanted in the right renal region of the recipient after explantation of the right kidney. The infra-hepatic caval vein of the graft was anastomosed with the infrahepatic caval vein of the recipient. The arterialization of the donor's portal vein was carried out via the recipient's right renal artery with the stent technique. The blood-flow regulation of the arterialized portal vein was achieved with the use of a stent with an internal diameter of 0.3 mm. The celiac trunk of the graft was end-to-side anastomosed with the recipient's aorta and the bile duct was implanted into the duodenum. A subtotal resection of the native liver was performed to induce acute hepatic failure. (7) In this manner 112 transplantations were performed. The perioperative survival rate was 90% and the 6-week survival rate was 80%. Six weeks after operation, the native liver regenerated, showing an increase in weight from 2.3±0.8 g to 9.8±1 g. At this time, the graft's weight decreased from 3.3±0.8 g to 2.3±0.8 g. We were able to obtain promising long-term results in terms of graft morphology and function. HALT with flow-regulated PVA reliably bridges acute hepatic failure until the native liver regenerates.
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Affiliation(s)
- Karina Schleimer
- European Vascular Center Aachen-Maastricht, Department of Vascular Surgery, University Hospital RWTH Aachen;
| | - Johannes Kalder
- European Vascular Center Aachen-Maastricht, Department of Vascular Surgery, University Hospital RWTH Aachen
| | - Jochen Grommes
- European Vascular Center Aachen-Maastricht, Department of Vascular Surgery, University Hospital RWTH Aachen
| | - Houman Jalaie
- European Vascular Center Aachen-Maastricht, Department of Vascular Surgery, University Hospital RWTH Aachen
| | - Samir Tawadros
- European Vascular Center Aachen-Maastricht, Department of Vascular Surgery, University Hospital RWTH Aachen
| | - Andreas Greiner
- European Vascular Center Aachen-Maastricht, Department of Vascular Surgery, University Hospital RWTH Aachen
| | - Michael Jacobs
- European Vascular Center Aachen-Maastricht, Department of Vascular Surgery, University Hospital RWTH Aachen
| | - Maria Kokozidou
- European Vascular Center Aachen-Maastricht, Department of Vascular Surgery, University Hospital RWTH Aachen
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Li WG, Chen YL, Chen JX, Qu L, Xue BD, Peng ZH, Huang ZQ. Portal venous arterialization resulting in increased portal inflow and portal vein wall thickness in rats. World J Gastroenterol 2008; 14:6681-8. [PMID: 19034971 PMCID: PMC2773310 DOI: 10.3748/wjg.14.6681] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To explore the influence of portal vein hemo-dynamic changes after portal venous arterialization (PVA) on peribiliary vascular plexus (PVP) morphological structure and hepatic pathology, and to establish a theoretical basis for the clinical application of PVA.
METHODS: Sprague-Dawley rats were randomly divided into control and PVA groups. After PVA, hemodynamic changes of the portal vein and morphological structure of hepatohilar PVP were observed using Doppler ultrasound, liver function tests, ink perfusion transparency management and three-dimensional reconstruction of computer microvisualization, and pathological examination was performed on tissue from the bile duct wall and the liver.
RESULTS: After PVA, the cross-sectional area and blood flow of the portal vein were increased, and the increase became more significant over time, in a certain range. If the measure to limit the flow in PVA was not adopted, the high blood flow would lead to dilatation of intrahepatic portal vein and its branches, increase in collagen and fiber degeneration in tunica intima. Except glutamic pyruvic transaminase (GPT), other liver function tests were normal.
CONCLUSION: Blood with a certain flow and oxygen content is important for filling the PVP and meeting the oxygen requirement of the bile duct wall. After PVA, It is the anatomic basis to maintain normal morphology of hepatohilar bile duct wall that the blood with high oxygen content and high flow in arterialized portal vein may fill PVP by collateral vessel reflux. A adequate measure to limit blood flow is necessary in PVA.
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Affiliation(s)
- Amit Singhal
- The Liver Unit, Queen Elizabeth Hospital, Birmingham and University of Birmingham, UK
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