Effect of cold ischemia/reperfusion injury and/or shear stress with portal hypertension on the expression of matrix metalloproteinase-9

Authors Tomohide Hori, Shinji Uemoto, Feng Chen, Ann-Marie T. Baine, Lindsay B. Gardner, Toshiyuki Hata, Kagemasa Kuribayashi, Takuma Kato, Kanako Saito, Linan Wang, Mie Torii, Kosuke Endo, Kanta Jobara, Beni Sulistiono, Justin H. Nguyen.


Background Matrix metalloproteinase (MMP)-9 plays an important role in liver regeneration after liver surgery. MMP-9 behavior is complicated in cold ischemia/warm reperfusion injury (CIWRI) and/or shear stress with portal hypertension. Small-for-size grafts (SFSGs) are also an issue.

Materials and Methods We used a rat model to examine MMP-9 expression 6 h after  laparotomy, a temporal clamp (Pringle maneuver), orthotopic liver transplantation (OLT) with a whole-liver graft (100% OLT), partial hepatectomy without the Pringle maneuver (60% hepatectomy) and split orthotopic liver transplantation (SOLT) with a SFSG (40% SOLT) were investigated. Four liver samples were collected in each group.

Results The normalized ratio of MMP-9 was not significantly different with a temporal clamp (P = 0.1963), 100% OLT (P = 0.1781) and 60% hepatectomy (P = 0.2367), but it was significantly higher with 40% SOLT compared to that with laparotomy (P = 0.0159).

Conclusion Forty percent SOLT is accompanied by not only CIWRI but also shear stress. This fatal damage results in increased MMP-9 expression.

Keywords extended hepatectomy, Pringle maneuver, remnant liver, split liver transplantation, small-for-size graft

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