Effect of preoperative interventions on outcome following liver resection in a rat model of cirrhosis

J Hepatol. 2000 Feb;32(2):287-92. doi: 10.1016/s0168-8278(00)80074-4.

Abstract

Background/aims: High morbidity and mortality rates in cirrhotic patients undergoing resections for hepatocellular malignancies underscore the need for identifying a therapy that will decrease fibrosis or enhance hepatic regenerative activity in the perioperative period. Thus, in the present study, 104 carbon tetrachloride-induced cirrhotic rats received either saline (untreated cirrhotic controls) or one of the following agents that have been reported to decrease hepatic fibrosis or increase hepatic regeneration; pentoxifylline, ciprofloxacin or a traditional Chinese herbal remedy (TCHR). Twelve additional rats served as healthy, non-cirrhotic controls.

Methods: Treatments were administered daily by gavage for 4 weeks followed by a 70% partial hepatectomy. Hepatic fibrosis was documented at the time of surgery by computer-assisted quantitation of collagen content. Liver function and hepatic regenerative activity were documented 24 h post partial hepatectomy by serum bilirubin determinations and a combination of 3[H]-Thymidine incorporation into hepatic DNA and proliferating cell nuclear antigen (PCNA) quantitation, respectively.

Results: Compared to untreated cirrhotic controls (8.1 +/- 0.7%), fibrosis was significantly reduced in the pentoxifylline- and ciprofloxacin-treated groups (4.6 +/- 0.2%, p<0.005 and 5.5 +/- 0.6%, p<0.05) but unchanged in the TCHR-treated group (6.6 +/- 11.0%). Post-operatively, total serum bilirubin levels were lower in the pentoxifylline (1.40 +/- 0.15 mg/dl,p<0.01) and ciprofloxacin (1.87 +/- 0.25 mg/dl, p<0.05)-treated groups, but unchanged in the TCHR group (2.20 +/- 0.45 mg/dl), when compared to untreated cirrhotic controls (3.00 +/- 0.37 mg/dl). Hepatic regenerative activity was also significantly improved in the pentoxifylline-treated group (17.8 +/- 2.2 versus 9.9 +/- 1.9 DPM/microg DNA in untreated cirrhotic controls, p<0.05), but unchanged in the ciprofloxacin (16.1 +/- 1.8 DPM/microg DNA) and TCHR (10.9 +/- 1.2 DPM/microg DNA)-treated groups. PCNA protein determinations were in keeping with the 3[H]-Thymidine results

Conclusions: Pre-operative pentoxifylline holds promise as a useful therapeutic intervention for patients with cirrhosis requiring hepatic resection.

MeSH terms

  • Animals
  • Anti-Infective Agents / therapeutic use*
  • Aspartate Aminotransferases / blood
  • Bilirubin / blood
  • Ciprofloxacin / therapeutic use*
  • Diagnosis, Computer-Assisted
  • Fibrosis
  • Liver / pathology
  • Liver / physiopathology
  • Liver / surgery*
  • Liver Cirrhosis, Experimental / pathology
  • Liver Cirrhosis, Experimental / physiopathology
  • Liver Cirrhosis, Experimental / surgery
  • Liver Cirrhosis, Experimental / therapy*
  • Liver Regeneration
  • Male
  • Medicine, Chinese Traditional*
  • Pentoxifylline / therapeutic use*
  • Phosphodiesterase Inhibitors / therapeutic use*
  • Preoperative Care*
  • Proliferating Cell Nuclear Antigen / metabolism
  • Rats
  • Rats, Sprague-Dawley
  • Survival Analysis
  • Thymidine / metabolism

Substances

  • Anti-Infective Agents
  • Phosphodiesterase Inhibitors
  • Proliferating Cell Nuclear Antigen
  • Ciprofloxacin
  • Aspartate Aminotransferases
  • Bilirubin
  • Pentoxifylline
  • Thymidine