Bernard Hemptinne - Academia.edu (original) (raw)
Papers by Bernard Hemptinne
Transplantation proceedings, 1993
Addiction Biology, 2001
ABSTRACT
Pediatric Transplantation, 2020
Background: HHH syndrome is a rare autosomal recessive disorder of the urea cycle, caused by a de... more Background: HHH syndrome is a rare autosomal recessive disorder of the urea cycle, caused by a deficient mitochondrial ornithine transporter. We report the first successful liver transplantation in HHH syndrome performed in a seven-year-old boy. The patient presented at 4 weeks of age with hyperammonemic coma. The plasma amino acid profile was suggestive of HHH syndrome, and the diagnosis was confirmed when sequencing of the SLC25A15 gene identified two mutations p.R275Q and p.A76D. Although immediate intervention resulted in normalization of plasma ammonia levels within 24 hours, he developed cerebral edema, coma, convulsions, and subsequent neurological sequelae. Metabolic control was difficult requiring severe protein restriction and continued treatment with sodium benzoate and L-arginine. Despite substantial developmental delay, he was referred to our center for liver transplantation because of poor metabolic control. Following cadaveric split liver transplantation, there was complete normalization of his plasma ammonia and plasma amino acid levels under a normal protein-containing diet. This excellent metabolic control was associated with a markedly improved general condition, mood and behavior, and small developmental achievements. Twelve years after liver transplantation, the patient has a stable cognitive impairment without progression of spastic diplegia. Conclusion: This first case of liver transplantation in HHH syndrome demonstrates that this procedure is a therapeutic option for HHH patients with difficult metabolic control.
Surgery, gynecology & obstetrics, 1992
The influence of ABO-compatibility was reviewed in 70 emergency orthotopic hepatic transplantatio... more The influence of ABO-compatibility was reviewed in 70 emergency orthotopic hepatic transplantations (OHT) performed at our institution in 60 highly urgent recipients between February 1984 and March 1989. Thirty-eight were ABO-identical (Id); 16, compatible (Comp), and 16, incompatible (Inc) transplants, respectively. The three groups did not differ statistically with respect to the indications, the adult/child ratio and the proportions of first OHT and retransplantations. Graft survival rates of ABO-Id, ABO-Comp and ABO-Inc OHT at one year were 47, 38 and 19 per cent, respectively (p less than 0.02). Incidences of perioperative mortality, arterial thrombosis and irreversible rejection were slightly (although not significantly) higher in the ABO-Inc group. Retransplantation rates were 19, 7 and 36 per cent in the ABO-Id, Comp and Inc groups, respectively. Patient survival rates at one year were 59 per cent for the ABO-Id group versus 43 per cent for both ABO-Comp and Inc combinations...
Transplantation Proceedings, 2007
Introduction. Donation after cardiac death has reemerged as a potential way of increasing the sup... more Introduction. Donation after cardiac death has reemerged as a potential way of increasing the supply of organs for transplantation. We retrospectively reviewed the outcomes of non-heart-beating donor (NHBD) liver transplantation (OLT) experience and compared with standard heart-beating donation (HBD) at a single center. Methods. From October 2003 to November 2006, 13/111 liver transplantations were performed in our institution with NHBD. Living donor liver transplantation, splitting procedures, combined, and pediatric liver transplantations were excluded from this analysis. Results. Donor population was similar in both groups. The median warm ischemia time was 10 minutes (range 6 to 38). The median cold ischemia times 6 hours and 16 minutes (2.4 to 6.30 hours and 9 hours and 14 minutes (2.15 to 15.35 hours) for NHBD and HBD groups, respectively (P ϭ .0002). In the NHBD groups, 4/13 (31%) grafts were retransplanted within 3 months, due to ischemic biliary lesions with severe cholestasis (n ϭ 3) or due to the occurrence of primary nonfunction (n ϭ 1). The retransplantation rate was significantly lower in the HBD group (11/98, 11%; P ϭ .03). One-year patient and graft survivals were 62% and 54% versus 86% and 79%, respectively, for the NHBD and HBD groups (P ϭ .107 and P ϭ .003). Conclusion. Liver grafts procured from donors after cardiac death accounted for a significantly greater retransplantation rates, mainly due to nonanastomotic biliary strictures. This risk must be taken into account when transplanting such grafts. Based upon this experience, NHBD cannot rival HBD to be a comparable source of quality organs for liver transplantation.
Obesity Surgery, 1999
Laparoscopic adjustable silicone gastric banding (LASGB) has become a widely used procedure for t... more Laparoscopic adjustable silicone gastric banding (LASGB) has become a widely used procedure for the treatment of morbid obesity. The original operation, as described by Kuzmak, has been subjected to modifications. Construction of a proximal gastric pouch is an important part of the operation. Until now, we used the technique of Niville. Since this was often complicated by gastric bleeding and/or serosal tears, we developed a new technique to construct a pouch. A new technique, using a thread previously fixed to that portion of the fundus that will be used to construct the pouch, is described. A safe and easy adaptation of the LASGB technique is proposed to create the gastric pouch.
Transplantation Proceedings, 1997
ABSTRACT HEPATIC artery chemoembolization (transcatheter arterial embolization [TAE]) is widely a... more ABSTRACT HEPATIC artery chemoembolization (transcatheter arterial embolization [TAE]) is widely applied in the treatment of unresectable hepatocellular carcinoma (HCC) and in carefully selected patients awaiting orthotopic liver transplantation (OLT).1 This procedure is generally safe and has shown significant tumor necrosis on hepatectomy specimens (partial or total).2 Recently, percutaneous alcohol injection (PEI) has been proposed as a less invasive modality treatment alternative to surgery for HCC.3 However, the efficacy of these procedures on patients' survival when used as a single treatment remains controversial. A combination of TAE-PEI has also been applied to enhance tumor necrosis by the synergistic effects of the double treatment.4 Moreover, there have been some reports showing the potential to achieve a high response rate and tumoral necrosis.5–6 The purpose of this study was to analyze histological results on total hepatectomy specimens of patients transplanted for HCC on cirrhosis after several sessions of combined TAE-PEI.
Endocrinology, 1989
Human livers, obtained from donors at the time of transplant, were homogenized in 0.25 M sucrose ... more Human livers, obtained from donors at the time of transplant, were homogenized in 0.25 M sucrose and fractionated by differential centrifugation. The specific binding of [125I] human (h) GH to total particulate fractions from 18 livers varied from 0.4-5.1% of the total radioactivity/100 micrograms protein. Binding affinity was 2.0 +/- 0.3 X 10(9) M-1, and binding capacity ranged from 14-53 fmol/mg protein. A different proportion of receptors occupied by endogenous hGH did not explain the large variation in binding. Binding sites were specific for hGH. Dissociation of the hormone-receptor complex was extremely slow. No specific binding of [125I]hPRL was observed. Specific binding of insulin was found in fractions from all livers and varied less than hGH binding. Cross-linking of [125I]hGH to plasma membrane and microsome receptors yielded two major autoradiographic bands corresponding to an estimated mol wt of 103,000 for the receptor, with a possible subunit of 54,000. Human liver primary fractions were characterized. The binding of hGH and insulin displayed a nucleo-microsomal distribution pattern in the primary fractions; 54.2% and 27.9% of the hGH-binding activity were found in the microsomes and the nuclear fraction, respectively, whereas insulin binds equally to nuclear and microsomal elements. Our findings suggest that hGH-binding sites are present in the plasma membrane and also in one or more intracellular compartments, whereas a high proportion of insulin receptors is associated with the plasma membrane.
J Hepatol, 2004
Background: We investigated the prevalence of occult HBV infection in a group of HBsAg-negative a... more Background: We investigated the prevalence of occult HBV infection in a group of HBsAg-negative and anti-HCV-negative (non-B, non-C or NBNC) patients with hepatocellular carcinoma (HCC) on cirrhosis in the time period preceding orthotopic liver transplantation (OLT) and the rate and persistence of HBV after OLT. Methods: Fourteen NBNC liver transplant recipients, followed for 1-5 years after OLT, were retrospectively tested for the presence of occult HBV before surgery. Six of them lacked HBV markers. DNA was extracted from serum and liver tissue by proteinase K and phenol/chloroform method. HBV DNA was detected by an in-house PCR amplification method (detection limit 500 copies/ml) with nested primers (nPCR) from highly conserved S-gene region encompassing a-determinant. Results: HBV DNA was detected in 2 pre-OLT serum samples in 7/14 liver transplantation candidates (5/8 anti-HBc positive and 2/6 anti-HBc negative). The reinfection of liver graft was documented in 4/7 candidates with occult HBV infection. HBV DNA was first detected in sera of these 4 recipients between 17-90 days after OLT and persisted up to 1-5 years of follow-up. HBsAg reactivity was detected about 16 months post-OLT in 1/4 recipients. After the detection of HBsAg in this patient, lamivudine treatment was initiated. HBV DNA remained detectable in all serum samples and follow-up biopsies after the sustained clearance of HBsAg that occurred two months after starting therapy. Conclusions: The detection of an occult HBV infection before OLT rises the option for immunoglobulin prophylaxis with or without adefovir treatment, given the frequent recurrence of HBV after OLT.
Clinical Transplantation, Mar 23, 2015
Transplantation Proceedings, 1997
Acta chirurgica Belgica
Hepatic resections are considered as a standard intervention in abdominal surgery. However there ... more Hepatic resections are considered as a standard intervention in abdominal surgery. However there is still a remarkable complication rate. Despite all recent developments in surgical techniques during liver surgery, blood loss is still one of the main causes for postoperative morbidity and mortality. In addition to patient-dependent factors, aspects of the surgical technique play a major role, in particular with regard to the occurrence of peri-operative bleeding, fluid accumulation and bile leakage. Nowadays, the use of topical sealants is often recommended as an additional tool to decrease postoperative bleeding and bile fistula. Fibrin sealants are able not only to enhance clot formation and wound healing, but possibly work as a sealing device for the small biliary branches. In this overview we will try to evaluate the efficacy in terms of time to complete haemostasis, the need for blood transfusions and the incidence of bile leakage according to recent trials. Furthermore the cli...
Langenbecks Archiv für Chirurgie. Supplement. Kongressband. Deutsche Gesellschaft für Chirurgie. Kongress, 1996
The results of orthotopic liver transplantation in patients > 55 years were compared to a grou... more The results of orthotopic liver transplantation in patients > 55 years were compared to a group of patients aged < or = 55 years. Rates of 1- and 4-year patient survival were 88.5% and 73.1% vs. 88.0% and 70.7%, respectively. Morbidity and postoperative mortality were similar in both groups, suggesting that orthotopic liver transplantation can be safely performed in patients > 55 years of age with excellent improvement of quality of life.
Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 2003
Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 2003
This article discusses the rationale behind living (related) donor liver transplantation, the rol... more This article discusses the rationale behind living (related) donor liver transplantation, the role of imaging in the preoperative evaluation of the potential donor, and the currently available imaging modalities for fulfilling this task. Furthermore, the normal hepatic vascular and biliary anatomy, as seen on imaging, is reviewed and the most common anomalies are highlighted. Finally, critical concepts in the diagnostic evaluation of a donor are discussed with special emphasis on how to accurately measure liver volumes.
The Anatomical Record, 2004
Following liver transplantation, all hepatic nerves are transected; thus, liver allografts are co... more Following liver transplantation, all hepatic nerves are transected; thus, liver allografts are completely isolated from neural control of their hosts. Despite this absolute denervation, liver allograft function does not appear to be significantly impaired after successful transplantation. In experimental animal models, hepatic denervation has no major effects on bile acid production and biotransformation, while it increases blood pressure and salt retention; decreases the number of hepatic progenitor cells, cholangiocyte proliferation, and liver regeneration; and influences the hepatic microcirculation, diet behavior, and glycemic control. In humans, hepatic denervation after liver transplantation has no major deleterious effects on bile secretion, liver regeneration, and hepatic blood flow. Insulin resistance and postprandial hyperglycemia, changes in ingestion behavior, and reduced stimulation of hepatic progenitor cells in the canals of Hering are the major side effects of absent liver innervation. Despite these abnormalities, patients can lead a new life with improved quality of life.
In the rat model of heterotopic auxiliary liver transplantation (HALTx), the opinion varies on wh... more In the rat model of heterotopic auxiliary liver transplantation (HALTx), the opinion varies on whether and how the recipient's native liver should be handicapped. To avoid atrophy of the transplanted organ, in this study, two different handicaps were evaluated and their effects on post-operative animal survival and liver biology are described. With a sole portacaval shunt (group 1) all rats survived longer than 3 months. An additional handicap of the liver with either a 68% partial hepatectomy (68% PH) (group 2), or both a 68% PH and a common bile duct ligation (CBDL) (group 3) led to a 100% mortality within 2 days after surgery. When an auxiliary liver was transplanted to the rats handicapped with a 68% PH (group 4), serum Bilirubin and ALAT values were significantly lower than those handicapped with both a 68% PH and a CBDL (group 5). Autopsy and histology of the long-term survivors revealed the atrophy of the engrafted livers and the regeneration of the native livers in group 4, whereas it showed the opposite in group 5. Thus the various manipulations of the native liver do influence differently the post-transplant animal survival, serum liver biochemistry and the outcome of the engrafted liver in this rat model of HALTx.
Transplantation proceedings, 1993
Addiction Biology, 2001
ABSTRACT
Pediatric Transplantation, 2020
Background: HHH syndrome is a rare autosomal recessive disorder of the urea cycle, caused by a de... more Background: HHH syndrome is a rare autosomal recessive disorder of the urea cycle, caused by a deficient mitochondrial ornithine transporter. We report the first successful liver transplantation in HHH syndrome performed in a seven-year-old boy. The patient presented at 4 weeks of age with hyperammonemic coma. The plasma amino acid profile was suggestive of HHH syndrome, and the diagnosis was confirmed when sequencing of the SLC25A15 gene identified two mutations p.R275Q and p.A76D. Although immediate intervention resulted in normalization of plasma ammonia levels within 24 hours, he developed cerebral edema, coma, convulsions, and subsequent neurological sequelae. Metabolic control was difficult requiring severe protein restriction and continued treatment with sodium benzoate and L-arginine. Despite substantial developmental delay, he was referred to our center for liver transplantation because of poor metabolic control. Following cadaveric split liver transplantation, there was complete normalization of his plasma ammonia and plasma amino acid levels under a normal protein-containing diet. This excellent metabolic control was associated with a markedly improved general condition, mood and behavior, and small developmental achievements. Twelve years after liver transplantation, the patient has a stable cognitive impairment without progression of spastic diplegia. Conclusion: This first case of liver transplantation in HHH syndrome demonstrates that this procedure is a therapeutic option for HHH patients with difficult metabolic control.
Surgery, gynecology & obstetrics, 1992
The influence of ABO-compatibility was reviewed in 70 emergency orthotopic hepatic transplantatio... more The influence of ABO-compatibility was reviewed in 70 emergency orthotopic hepatic transplantations (OHT) performed at our institution in 60 highly urgent recipients between February 1984 and March 1989. Thirty-eight were ABO-identical (Id); 16, compatible (Comp), and 16, incompatible (Inc) transplants, respectively. The three groups did not differ statistically with respect to the indications, the adult/child ratio and the proportions of first OHT and retransplantations. Graft survival rates of ABO-Id, ABO-Comp and ABO-Inc OHT at one year were 47, 38 and 19 per cent, respectively (p less than 0.02). Incidences of perioperative mortality, arterial thrombosis and irreversible rejection were slightly (although not significantly) higher in the ABO-Inc group. Retransplantation rates were 19, 7 and 36 per cent in the ABO-Id, Comp and Inc groups, respectively. Patient survival rates at one year were 59 per cent for the ABO-Id group versus 43 per cent for both ABO-Comp and Inc combinations...
Transplantation Proceedings, 2007
Introduction. Donation after cardiac death has reemerged as a potential way of increasing the sup... more Introduction. Donation after cardiac death has reemerged as a potential way of increasing the supply of organs for transplantation. We retrospectively reviewed the outcomes of non-heart-beating donor (NHBD) liver transplantation (OLT) experience and compared with standard heart-beating donation (HBD) at a single center. Methods. From October 2003 to November 2006, 13/111 liver transplantations were performed in our institution with NHBD. Living donor liver transplantation, splitting procedures, combined, and pediatric liver transplantations were excluded from this analysis. Results. Donor population was similar in both groups. The median warm ischemia time was 10 minutes (range 6 to 38). The median cold ischemia times 6 hours and 16 minutes (2.4 to 6.30 hours and 9 hours and 14 minutes (2.15 to 15.35 hours) for NHBD and HBD groups, respectively (P ϭ .0002). In the NHBD groups, 4/13 (31%) grafts were retransplanted within 3 months, due to ischemic biliary lesions with severe cholestasis (n ϭ 3) or due to the occurrence of primary nonfunction (n ϭ 1). The retransplantation rate was significantly lower in the HBD group (11/98, 11%; P ϭ .03). One-year patient and graft survivals were 62% and 54% versus 86% and 79%, respectively, for the NHBD and HBD groups (P ϭ .107 and P ϭ .003). Conclusion. Liver grafts procured from donors after cardiac death accounted for a significantly greater retransplantation rates, mainly due to nonanastomotic biliary strictures. This risk must be taken into account when transplanting such grafts. Based upon this experience, NHBD cannot rival HBD to be a comparable source of quality organs for liver transplantation.
Obesity Surgery, 1999
Laparoscopic adjustable silicone gastric banding (LASGB) has become a widely used procedure for t... more Laparoscopic adjustable silicone gastric banding (LASGB) has become a widely used procedure for the treatment of morbid obesity. The original operation, as described by Kuzmak, has been subjected to modifications. Construction of a proximal gastric pouch is an important part of the operation. Until now, we used the technique of Niville. Since this was often complicated by gastric bleeding and/or serosal tears, we developed a new technique to construct a pouch. A new technique, using a thread previously fixed to that portion of the fundus that will be used to construct the pouch, is described. A safe and easy adaptation of the LASGB technique is proposed to create the gastric pouch.
Transplantation Proceedings, 1997
ABSTRACT HEPATIC artery chemoembolization (transcatheter arterial embolization [TAE]) is widely a... more ABSTRACT HEPATIC artery chemoembolization (transcatheter arterial embolization [TAE]) is widely applied in the treatment of unresectable hepatocellular carcinoma (HCC) and in carefully selected patients awaiting orthotopic liver transplantation (OLT).1 This procedure is generally safe and has shown significant tumor necrosis on hepatectomy specimens (partial or total).2 Recently, percutaneous alcohol injection (PEI) has been proposed as a less invasive modality treatment alternative to surgery for HCC.3 However, the efficacy of these procedures on patients' survival when used as a single treatment remains controversial. A combination of TAE-PEI has also been applied to enhance tumor necrosis by the synergistic effects of the double treatment.4 Moreover, there have been some reports showing the potential to achieve a high response rate and tumoral necrosis.5–6 The purpose of this study was to analyze histological results on total hepatectomy specimens of patients transplanted for HCC on cirrhosis after several sessions of combined TAE-PEI.
Endocrinology, 1989
Human livers, obtained from donors at the time of transplant, were homogenized in 0.25 M sucrose ... more Human livers, obtained from donors at the time of transplant, were homogenized in 0.25 M sucrose and fractionated by differential centrifugation. The specific binding of [125I] human (h) GH to total particulate fractions from 18 livers varied from 0.4-5.1% of the total radioactivity/100 micrograms protein. Binding affinity was 2.0 +/- 0.3 X 10(9) M-1, and binding capacity ranged from 14-53 fmol/mg protein. A different proportion of receptors occupied by endogenous hGH did not explain the large variation in binding. Binding sites were specific for hGH. Dissociation of the hormone-receptor complex was extremely slow. No specific binding of [125I]hPRL was observed. Specific binding of insulin was found in fractions from all livers and varied less than hGH binding. Cross-linking of [125I]hGH to plasma membrane and microsome receptors yielded two major autoradiographic bands corresponding to an estimated mol wt of 103,000 for the receptor, with a possible subunit of 54,000. Human liver primary fractions were characterized. The binding of hGH and insulin displayed a nucleo-microsomal distribution pattern in the primary fractions; 54.2% and 27.9% of the hGH-binding activity were found in the microsomes and the nuclear fraction, respectively, whereas insulin binds equally to nuclear and microsomal elements. Our findings suggest that hGH-binding sites are present in the plasma membrane and also in one or more intracellular compartments, whereas a high proportion of insulin receptors is associated with the plasma membrane.
J Hepatol, 2004
Background: We investigated the prevalence of occult HBV infection in a group of HBsAg-negative a... more Background: We investigated the prevalence of occult HBV infection in a group of HBsAg-negative and anti-HCV-negative (non-B, non-C or NBNC) patients with hepatocellular carcinoma (HCC) on cirrhosis in the time period preceding orthotopic liver transplantation (OLT) and the rate and persistence of HBV after OLT. Methods: Fourteen NBNC liver transplant recipients, followed for 1-5 years after OLT, were retrospectively tested for the presence of occult HBV before surgery. Six of them lacked HBV markers. DNA was extracted from serum and liver tissue by proteinase K and phenol/chloroform method. HBV DNA was detected by an in-house PCR amplification method (detection limit 500 copies/ml) with nested primers (nPCR) from highly conserved S-gene region encompassing a-determinant. Results: HBV DNA was detected in 2 pre-OLT serum samples in 7/14 liver transplantation candidates (5/8 anti-HBc positive and 2/6 anti-HBc negative). The reinfection of liver graft was documented in 4/7 candidates with occult HBV infection. HBV DNA was first detected in sera of these 4 recipients between 17-90 days after OLT and persisted up to 1-5 years of follow-up. HBsAg reactivity was detected about 16 months post-OLT in 1/4 recipients. After the detection of HBsAg in this patient, lamivudine treatment was initiated. HBV DNA remained detectable in all serum samples and follow-up biopsies after the sustained clearance of HBsAg that occurred two months after starting therapy. Conclusions: The detection of an occult HBV infection before OLT rises the option for immunoglobulin prophylaxis with or without adefovir treatment, given the frequent recurrence of HBV after OLT.
Clinical Transplantation, Mar 23, 2015
Transplantation Proceedings, 1997
Acta chirurgica Belgica
Hepatic resections are considered as a standard intervention in abdominal surgery. However there ... more Hepatic resections are considered as a standard intervention in abdominal surgery. However there is still a remarkable complication rate. Despite all recent developments in surgical techniques during liver surgery, blood loss is still one of the main causes for postoperative morbidity and mortality. In addition to patient-dependent factors, aspects of the surgical technique play a major role, in particular with regard to the occurrence of peri-operative bleeding, fluid accumulation and bile leakage. Nowadays, the use of topical sealants is often recommended as an additional tool to decrease postoperative bleeding and bile fistula. Fibrin sealants are able not only to enhance clot formation and wound healing, but possibly work as a sealing device for the small biliary branches. In this overview we will try to evaluate the efficacy in terms of time to complete haemostasis, the need for blood transfusions and the incidence of bile leakage according to recent trials. Furthermore the cli...
Langenbecks Archiv für Chirurgie. Supplement. Kongressband. Deutsche Gesellschaft für Chirurgie. Kongress, 1996
The results of orthotopic liver transplantation in patients > 55 years were compared to a grou... more The results of orthotopic liver transplantation in patients > 55 years were compared to a group of patients aged < or = 55 years. Rates of 1- and 4-year patient survival were 88.5% and 73.1% vs. 88.0% and 70.7%, respectively. Morbidity and postoperative mortality were similar in both groups, suggesting that orthotopic liver transplantation can be safely performed in patients > 55 years of age with excellent improvement of quality of life.
Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 2003
Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 2003
This article discusses the rationale behind living (related) donor liver transplantation, the rol... more This article discusses the rationale behind living (related) donor liver transplantation, the role of imaging in the preoperative evaluation of the potential donor, and the currently available imaging modalities for fulfilling this task. Furthermore, the normal hepatic vascular and biliary anatomy, as seen on imaging, is reviewed and the most common anomalies are highlighted. Finally, critical concepts in the diagnostic evaluation of a donor are discussed with special emphasis on how to accurately measure liver volumes.
The Anatomical Record, 2004
Following liver transplantation, all hepatic nerves are transected; thus, liver allografts are co... more Following liver transplantation, all hepatic nerves are transected; thus, liver allografts are completely isolated from neural control of their hosts. Despite this absolute denervation, liver allograft function does not appear to be significantly impaired after successful transplantation. In experimental animal models, hepatic denervation has no major effects on bile acid production and biotransformation, while it increases blood pressure and salt retention; decreases the number of hepatic progenitor cells, cholangiocyte proliferation, and liver regeneration; and influences the hepatic microcirculation, diet behavior, and glycemic control. In humans, hepatic denervation after liver transplantation has no major deleterious effects on bile secretion, liver regeneration, and hepatic blood flow. Insulin resistance and postprandial hyperglycemia, changes in ingestion behavior, and reduced stimulation of hepatic progenitor cells in the canals of Hering are the major side effects of absent liver innervation. Despite these abnormalities, patients can lead a new life with improved quality of life.
In the rat model of heterotopic auxiliary liver transplantation (HALTx), the opinion varies on wh... more In the rat model of heterotopic auxiliary liver transplantation (HALTx), the opinion varies on whether and how the recipient's native liver should be handicapped. To avoid atrophy of the transplanted organ, in this study, two different handicaps were evaluated and their effects on post-operative animal survival and liver biology are described. With a sole portacaval shunt (group 1) all rats survived longer than 3 months. An additional handicap of the liver with either a 68% partial hepatectomy (68% PH) (group 2), or both a 68% PH and a common bile duct ligation (CBDL) (group 3) led to a 100% mortality within 2 days after surgery. When an auxiliary liver was transplanted to the rats handicapped with a 68% PH (group 4), serum Bilirubin and ALAT values were significantly lower than those handicapped with both a 68% PH and a CBDL (group 5). Autopsy and histology of the long-term survivors revealed the atrophy of the engrafted livers and the regeneration of the native livers in group 4, whereas it showed the opposite in group 5. Thus the various manipulations of the native liver do influence differently the post-transplant animal survival, serum liver biochemistry and the outcome of the engrafted liver in this rat model of HALTx.