Brief Article
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Nov 21, 2012; 18(43): 6308-6314
Published online Nov 21, 2012. doi: 10.3748/wjg.v18.i43.6308
Effects of warm ischemia time on biliary injury in rat liver transplantation
Xin-Hua Zhu, Jun-Ping Pan, Ya-Fu Wu, Yi-Tao Ding
Xin-Hua Zhu, Jun-Ping Pan, Ya-Fu Wu, Yi-Tao Ding, Department of Hepatobiliary Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing 210008, Jiangsu Province, China
Author contributions: Zhu XH performed the literature review and part of the surgical procedure, prepared the manuscript and performed the statistical analysis; Pan JP performed part of the surgical procedure and assessment; Wu YF supervised manuscript preparation and formulated the experimental protocol; Ding YT supervised manuscript preparation and assisted in the experimental protocol formulation.
Supported by Grants from Jiangsu Provincial government, China, No. ZX200605
Correspondence to: Ya-Fu Wu, MD, Department of Hepatobiliary Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, No. 321, Zhongshan Road, Nanjing 210008, Jiangsu Province, China. drwuyafu@163.com
Telephone: +86-25-83304616 Fax: +86-25-83317016
Received: May 22, 2012
Revised: July 31, 2012
Accepted: August 26, 2012
Published online: November 21, 2012
Abstract

AIM: To investigate the effect of different secondary warm ischemia time (SWIT) on bile duct injury in liver-transplanted rats.

METHODS: Forty-eight male inbred Sprague-Dawley rats were randomly assigned into four groups: a sham-operation group and three groups with secondary biliary warm ischemia time of 0 min, 10 min and 20 min. A rat model of autologous liver transplantation under ether anesthesia was established, and six rats were killed in each group and blood samples and the median lobe of the liver were collected for assay at 6 h and 24 h after hepatic arterial reperfusion.

RESULTS: With prolongation of biliary warm ischemia time, the level of vascular endothelial growth factor-A was significantly decreased, and the value at 24 h was higher than that at 6 h after hepatic arterial reperfusion, but with no significant difference. The extended biliary SWIT led to a significant increase in bile duct epithelial cell apoptosis, and a decrease in the number of blood vessels, the bile duct surrounding the blood vessels and bile duct epithelial cell proliferation in the early postoperative portal area. Pathologic examinations showed that inflammation of the rat portal area was aggravated, and biliary epithelial cell injury was significantly worsened.

CONCLUSION: A prolonged biliary warm ischemia time results in aggravated injury of the bile duct and the surrounding vascular plexus in rat autologous orthotopic liver transplantation.

Keywords: Bile duct, Liver, Transplantation, Warm ischemia, Rat