Hepatic regeneration inflammatory markers profile in ALPPS procedure in porcine model

• Grant number: 16/15696-9
• Support Opportunities: Regular Research Grants
• Start date: December 01, 2016
• End date: August 31, 2019
• Field of knowledge: Health Sciences - Medicine - Surgery
• Principal Investigator: Marcelo Moura Linhares
• Grantee: Marcelo Moura Linhares
• Host Institution: Escola Paulista de Medicina (EPM). Universidade Federal de São Paulo (UNIFESP). Campus São Paulo. São Paulo , SP, Brazil

Abstract

Introduction: Associated liver partition and portal vein ligation for staged hepatectomy (ALPPS) is novel a surgical technique to induce hepatic regeneration in patients undergoing major hepatic resections and whose future remnant liver volume is insufficient. It has been observed that ALPPS leads to much faster hepatic regeneration when compared to portal vein ligation or embolization. So far, knowledge about physiological mechanism underlying hepatic regeneration after ALPPS is not yet fully understood. Objective: 1 - Determine, through an experimental study in porcine model, the profile of blood inflammatory markers associated to ALPPS procedure. 2 - Compare this profile with that present in the portal vein ligation (LVP) group. 3 - To determine the contribution of the deportalized liver in hepatic regeneration after ALPPS. Method: Fourteen pigs will be divided into 2 groups. In the LVP group, they will be submitted the ligation of branches of the portal vein (LVP). The ALPPS group will undergo associated portal vein ligation and hepatic bipartition for staged hepatectomy (ALPPS). Blood samples will be collected immediately before the first surgery, and also on the first, third and seventh days after surgery and will be held the following dosages of cytokines by Luminex method: IL-1±, IL 1², IL-1ra, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12, IL-18 and TNF-alfa. The following biochemical markers will also be measured in serum: aspartate aminotransferase, alanine aminotransferase, bilirubin, alkaline phosphatase, gamma glutamyl transferase, albumin, protrombine time, and C reactive protein. On the seventh postoperative day, the animals will be sacrificed and the liver will be taken for histopathological examination. (AU)