Portal blood arterialization with an extracorporeal device to treat toxic acute hepatic failure in a swine model

Int J Artif Organs. 2014 Nov;37(11):847-53. doi: 10.5301/ijao.5000367. Epub 2014 Dec 4.

Abstract

Purpose: This study aimed to determine whether a controlled portal blood arterialization by a liver extracorporeal device (L.E.O2 NARDO) is effective in treating acute hepatic failure (AHF) induced through CCl4 administration in a swine model.

Methods: 20 swine with AHF induced by intraperitoneal injection of carbon tetrachloride (CCl4) in oil solution, were randomly divided into two groups: animals receiving L.E.O2 NARDO treatment 48 h after the intoxication (study group); animals sham operated 48 h after the intoxication (control group). Blood was withdrawn from the iliac artery and reversed in the portal venous system by an interposed extracorporeal device. Each treatment lasted 6 h. The survival was assessed at 5 days after L.E.O2 NARDO treatment or sham operation. In both groups blood samples were collected for biochemical analysis at different time points and liver biopsies were collected 48 h after intoxication and at sacrifice.

Results: We observed decreased transaminases levels and a more rapid INR recovery in the study group, as compared to the control group. Eight animals of the study group vs. two animals of the control group survived at five days after surgery with a statistically significant difference (p<0.05). Liver biopsies performed at sacrifice showed a reduction of the damaged hepatic areas in the study group as compared to the control group.

Conclusions: Arterial blood supply in the portal system through the L.E.O2 NARDO device is easily applicable, efficacious, and safe in a swine model of AHF induced by CCl4 intoxication.

MeSH terms

  • Animals
  • Biomarkers / blood
  • Biopsy
  • Carbon Tetrachloride
  • Chemical and Drug Induced Liver Injury / blood
  • Chemical and Drug Induced Liver Injury / etiology
  • Chemical and Drug Induced Liver Injury / therapy*
  • Disease Models, Animal
  • Equipment Design
  • Extracorporeal Circulation / instrumentation*
  • Feasibility Studies
  • Female
  • Hepatectomy
  • Humans
  • International Normalized Ratio
  • Liver Circulation*
  • Liver Failure, Acute / blood
  • Liver Failure, Acute / chemically induced
  • Liver Failure, Acute / therapy*
  • Materials Testing
  • Portal Vein / physiopathology*
  • Swine
  • Time Factors

Substances

  • Biomarkers
  • Carbon Tetrachloride