Brief Articles
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World J Gastroenterol. Sep 28, 2009; 15(36): 4571-4575
Published online Sep 28, 2009. doi: 10.3748/wjg.15.4571
Hemoperfusion with polymyxin B-immobilized fiber column improves liver function after ischemia-reperfusion injury
Hiroaki Sato, Kiyohiro Oshima, Katsumi Kobayashi, Hodaka Yamazaki, Yujin Suto, Izumi Takeyoshi
Hiroaki Sato, Katsumi Kobayashi, Hodaka Yamazaki, Yujin Suto, Izumi Takeyoshi, Department of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, Maebashi, Gunma 371-8511, Japan
Kiyohiro Oshima, Intensive Care Unit, Gunma University Hospital, 3-39-15 Showa-machi, Maebashi, Gunma 371-8511, Japan
Author contributions: Sato H, Oshima K and Takeyoshi I designed the research; Sato H, Kobayashi K, Yamazaki H and Suto Y performed the research; Sato H and Oshima K analyzed the data, and Oshima K and Takeyoshi I wrote the paper.
Correspondence to: Izumi Takeyoshi, MD, Professor and Chairman, Department of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, Maebashi, Gunma 371-8511, Japan. takeyosi@showa.gunma-u.ac.jp
Telephone: +81-27-2208245 Fax: +81-27-2208255
Received: July 3, 2009
Revised: August 3, 2009
Accepted: August 10, 2009
Published online: September 28, 2009
Abstract

AIM: To investigate the usefulness of direct hemoperfusion with a polymyxin B-immobilized fiber column (DHP-PMX therapy) for warm hepatic ischemia-reperfusion (I/R) injury after total hepatic vascular exclusion (THVE) using a porcine model.

METHODS: Eleven Mexican hairless pigs weighing 22-38 kg were subjected to THVE for 120 min and then observed for 360 min. The animals were divided into two groups randomly: the DHP-PMX group (n = 5) underwent DHP-PMX at a flow rate of 80 mL/min for 120 min (beginning 10 min before reperfusion), while the control group did not (n = 6). The rate pressure product (RPP): heart rate × end-systolic arterial blood pressure, hepatic tissue blood flow (HTBF), portal vein blood flow (PVBF), and serum aspartate aminotransferase (AST) levels were compared between the two groups.

RESULTS: RPP and HTBF were significantly (P < 0.05) higher in the DHP-PMX group than in the control group 240 and 360 min after reperfusion. PVBF in the DHP-PMX group was maintained at about 70% of the flow before ischemia and differed significantly (P < 0.05) compared to the control group 360 min after reperfusion. The serum AST increased gradually after reperfusion in both groups, but the AST was significantly (P < 0.05) lower in the DHP-PMX group 360 min after reperfusion.

CONCLUSION: DHP-PMX therapy reduced the hepatic warm I/R injury caused by THVE in a porcine model.

Keywords: Ischemia-reperfusion injury; Total hepatic vascular exclusion; Polymyxin B-immobilized fiber column