Effect of Long-Term Octreotide and Isosorbide Dinitrate on Haemodynamics in Rats with Portal Vein Stenosis

1. Both octreotide and isosorbide dinitrate have been shown to have portal hypotensive effects in animals with portal hypertension. Moreover, in both animals and humans with portal hypertension, the reduction of portal pressure was enhanced when nitrovasodilators were combined with propranolol or vasopressin. The present study was undertaken to evaluate the effect of long-term administration of octreotide and isosorbide dinitrate on haemodynamics in rats with portal vein stenosis. 2. Portal hypertension was induced by portal vein stenosis. Portal hypertensive rats were allocated into one of four groups (eight rats in each group): vehicle group, octreotide group (100 μg/kg via subcutaneous injection every 12 h), isosorbide dinitrate group (5 mg/kg via gastric gavage every 12 h) and combined treatment group. Drug was given for eight consecutive days, starting 1 day before surgery. Haemodynamic values were measured using a radioactive microsphere technique. 3. Long-term octreotide treatment decreased portal pressure and improved the hyperdynamic circulation. In contrast, long-term administration of isosorbide dinitrate reduced portal pressure but did not ameliorate vasodilatation. A combination of octreotide and isosorbide dinitrate improved the hyperdynamic circulation with a reduction of portal pressure. In addition, the mean value of portal pressure after combination treatment was significantly lower than in rats receiving octreotide alone. 4. These results showed that, in rats with portal hypertension, long-term combined administration of octreotide and isosorbide dinitrate improved the hyperdynamic circulation together with a more profound reduction of portal pressure than rats receiving octreotide alone.

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Correction of extrahepatic portal hypertension in pediatric patient after liver transplantation

Russian Journal of Transplantology and Artificial Organs ◽

10.15825/1995-1191-2017-1-47-51 ◽

2017 ◽

Vol 19 (1) ◽

pp. 47-51

Author(s):

A. R. Monakhov ◽

B. L. Mironkov ◽

T. A. Dzhanbekov ◽

K. O. Semash ◽

Kh. M. Khizroev ◽

...

Keyword(s):

Liver Transplantation ◽

Blood Flow ◽

Portal Hypertension ◽

Portal Vein ◽

Pediatric Patient ◽

Portal Blood Flow ◽

Portal Blood ◽

Positive Trend ◽

Portal Vein Stenosis ◽

Vein Stenosis

Introduction. Liver transplantation is a multi-component and complex type of operative treatment. Patients undergoing such a treatment sometimes are getting various complications. One of these complications is a portal hypertension associated with portal vein stenosis.Materials and methods. In 6 years after the left lateral section transplantation from living donor in a pediatric patient the signs of portal hypertension were observed. Stenosis of the portal vein was revealed. Due to this fact percutaneous transhepatic correction of portal vein stenosis was performed.Results. As a result of the correction of portal blood flow in the patient a positive trend was noted. According to the laboratory and instrumental methods of examination the graft had a normal function, portal blood flow was adequate. In order to control the stent patency Doppler ultrasound and MSCT of the abdominal cavity with intravenous bolus contrasting were performed. Due to these examinations the stent function was good, the rate of blood flow in the portal vein due to Doppler data has reached 80 cm/sec, and a decrease of the spleen size was noted.Conclusion. Diagnosis and timely detection of portal vein stenosis in patients after liver transplantation are very important for the preservation of graft function and for the prevention of portal hypertension. In order to do that, ultrasound Doppler fluorimetry examination needs to be performed to each patient after liver transplantation. In cases of violation of the blood flow in the portal vein CT angiography performance is needed. Percutaneous transhepatic stenting of portal vein is a minimally invasive and highly effective method of correction of portal hypertension. Antiplatelet therapy and platelet aggregation control are the prerequisites for successful stent function.

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Portal vein stenosis and occlusion stenting after liver transplantation in two adults

Acta Radiologica ◽

10.1080/02841850500444705 ◽

2006 ◽

Vol 47 (2) ◽

pp. 130-134 ◽

Cited By ~ 4

Author(s):

A. Alfidja ◽

A. Abergel ◽

P. Chabrot ◽

D. Pezet ◽

C. Bony ◽

...

Keyword(s):

Liver Transplantation ◽

Portal Vein ◽

Orthotopic Liver Transplantation ◽

Adult Patients ◽

Portal Vein Stenosis ◽

Vein Stenosis ◽

Stenosis And Occlusion ◽

Term Management

We report two cases of percutaneous transhepatic stenting of the portal vein to treat stenosis and occlusion disclosed 5 and 18 months, respectively, after orthotopic liver transplantation in two adult patients. If long-term patency is satisfactory, this technique should allow long-term management of portal vein stenosis and occlusion without the use of thrombolysis.

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Free and conjugated plasma catecholamines in normal rats and in rats with portal hypertension due to portal vein stenosis

Journal of Hepatology ◽

10.1016/s0168-8278(85)80511-0 ◽

1985 ◽

Vol 1 ◽

pp. S238

Keyword(s):

Portal Hypertension ◽

Portal Vein ◽

Plasma Catecholamines ◽

Portal Vein Stenosis ◽

Vein Stenosis

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A Case of Pancreatic Abscess Causing Portal Vein Stenosis Leading to Portal Hypertension

The American Journal of Gastroenterology ◽

10.14309/00000434-201810001-02392 ◽

2018 ◽

Vol 113 (Supplement) ◽

pp. S1336-S1337

Author(s):

Sarang Thaker ◽

Sanmeet Singh ◽

Christine Chan

Keyword(s):

Portal Hypertension ◽

Portal Vein ◽

Pancreatic Abscess ◽

Portal Vein Stenosis ◽

Vein Stenosis

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A Novel Canine Model of Portal Vein Stenosis Plus Thioacetamide Administration-Induced Cirrhotic Portal Hypertension With Hypersplenism

Cell Biochemistry and Biophysics ◽

10.1007/s12013-011-9272-7 ◽

2011 ◽

Vol 62 (1) ◽

pp. 245-255 ◽

Cited By ~ 2

Author(s):

Dexin Lin ◽

Xianbin Wu ◽

Xiaoke Ji ◽

Qiyu Zhang ◽

YuanWei Lin ◽

...

Keyword(s):

Portal Hypertension ◽

Portal Vein ◽

Canine Model ◽

Portal Vein Stenosis ◽

Vein Stenosis

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Jejunal varices as a rare cause of recurrent gastrointestinal bleeding in a 74-year-old man with extrahepatic portal hypertension after pancreato-biliary surgery

BMJ Case Reports ◽

10.1136/bcr-2018-228527 ◽

2019 ◽

Vol 12 (3) ◽

pp. e228527

Author(s):

Philipp Kasper ◽

Christoph Schramm ◽

Natalie Jaspers ◽

Tobias Goeser

Keyword(s):

Gastrointestinal Bleeding ◽

Portal Vein ◽

Portal Pressure ◽

Biliary Surgery ◽

Jejunal Varices ◽

Portal Vein Stenosis ◽

History Of ◽

Endovascular Stent Placement ◽

Diagnostic Work ◽

Vein Stenosis

A 74-year-old man presented to our hospital with recurrent lower gastrointestinal bleeding. His past medical history was remarkable for a duodenal papilla carcinoma and he underwent a pylorus-preserving pancreaticoduodenectomy 4 years before. During diagnostic work-up a severe portal vein stenosis after surgery and multiple dilated intramural jejunal varices, which formed as collateral pathways could be detected. Based on these findings, the recurrent haemorrhages were considered to be due to repeated rupturing and bleeding of jejunal varices. Therapeutically, the portal vein stenosis was treated with endovascular stent placement leading to a reduction in prestenotic portal pressure. During follow-up no further episodes of gastrointestinal bleeding were observed. Bleeding from jejunal varices is a very rare cause of gastrointestinal haemorrhages and represents a diagnostic and therapeutic challenge. However, it should be considered in differential diagnosis of obscure recurrent gastrointestinal haemorrhages in patients with a history of hepato-pancreato-biliary surgery.

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Effects of pentobarbital sodium anesthesia on splanchnic hemodynamics of normal and portal-hypertensive rats

AJP Gastrointestinal and Liver Physiology ◽

10.1152/ajpgi.1985.249.4.g528 ◽

1985 ◽

Vol 249 (4) ◽

pp. G528-G532 ◽

Cited By ~ 6

Author(s):

S. S. Lee ◽

C. Girod ◽

D. Valla ◽

P. Geoffroy ◽

D. Lebrec

Keyword(s):

Blood Flow ◽

Cardiac Output ◽

Portal Hypertension ◽

Portal Vein ◽

Regional Blood Flow ◽

Hypertensive Rats ◽

Pentobarbital Sodium ◽

Portal Vein Stenosis ◽

Pentobarbital Sodium Anesthesia ◽

Vein Stenosis

To determine the effect of pentobarbital sodium anesthesia on the rat with portal hypertension due to portal vein stenosis, four groups of rats were studied. Cardiac output and regional blood flow were measured by radioactive microspheres in anesthetized and conscious sham-operated and portal-hypertensive rats. Anesthesia markedly decreased cardiac output in both sham-operated (109.7 +/- 4.6 vs. 77.8 +/- 1.4 ml/min, P less than 0.001) and portal-hypertensive rats (130.1 +/- 7.6 vs. 93.8 +/- 5.3 ml/min, P less than 0.01). In spite of this diminution in cardiac output, pentobarbital did not significantly change absolute blood flow values of splanchnic organs in either group. However, the fractions of cardiac output perfusing the splanchnic organs were significantly increased by pentobarbital in both groups because of the decrease in cardiac output: sham operated, anesthetized, 22.86 +/- 1.19% vs. conscious, 14.83 +/- 1.02%, P less than 0.001; and portal hypertensive, anesthetized, 26.67 +/- 0.71% vs. conscious, 19.07 +/- 1.44%, P less than 0.001. The hyperdynamic circulation of the portal vein-stenosed rat compared with the sham-operated rat continued to manifest itself with significantly increased portal pressure, cardiac output, and splanchnic blood flow, whether the animal was anesthetized or awake. We conclude that, despite marked hemodynamic changes induced by pentobarbital, the rat with portal vein stenosis remains a useful experimental model of portal hypertension.

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Extrahepatic Portal Hypertension following Liver Transplantation: a Rare but Challenging Problem

HPB Surgery ◽

10.1155/1998/81832 ◽

1998 ◽

Vol 10 (6) ◽

pp. 357-364 ◽

Cited By ~ 12

Author(s):

B. Malassagne ◽

O. Soubrane ◽

B. Dousset ◽

P. Legmann ◽

D. Houssin

Keyword(s):

Liver Transplantation ◽

Portal Hypertension ◽

Portal Vein ◽

Surgical Reconstruction ◽

Clinical Feature ◽

Complete Relief ◽

Venous Flow ◽

Extrahepatic Portal Hypertension ◽

Portal Vein Stenosis ◽

Vein Stenosis

This study reports our experience of 8 cases of extrahepatic portal hypertension after 273 orthotopic liver transplantations in 244 adult patients over a 10- year period. The main clinical feature was ascites, and the life-threatening complication was variceal bleeding. Extrahepatic portal hypertension was caused by portal vein stenosis in 6 patients, and left-sided portal hypertension in 2 patients after inadventent ligation of portal venous tributaries or portasystemic shunts. All patients with portal vein stenosis had complete relief of portal hypertension after percutaneous transhepatic venoplasty (n=4) or surgical reconstruction (n=2), after a median follow-up of 33 (range: 6–62) months. Of the 2 patients with left-sided portal hypertension, one died after splenectomy and one rebled 6 months after left colectomy. This study suggests that extrahepatic portal hypertension is a series complication after liver transplantation that could be prevented by meticulous portal anastomosis and closure of portal tributaries or portasystemic shunts to improve the portal venous flow. However, any ligation has to be performed under ultrasound guidance to avoid inadventent venous ligations.

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Effect of Two Models of Portal Hypertension on Splanchnic Organ Blood Flow in the Rat

Clinical Science ◽

10.1042/cs0680023 ◽

1985 ◽

Vol 68 (1) ◽

pp. 23-28 ◽

Cited By ~ 47

Author(s):

D. Lebrec ◽

L. Blanchet

Keyword(s):

Blood Flow ◽

Cardiac Output ◽

Portal Hypertension ◽

Portal Vein ◽

Arterial Blood Flow ◽

Organ Blood Flow ◽

Portal Vein Stenosis ◽

Arterial Blood ◽

Duct Ligation ◽

Vein Stenosis

1. Splanchnic organ blood flow and cardiac output were measured by the microsphere method in fasted rats with prehepatic portal hypertension due to portal vein stenosis, in rats with intrahepatic portal hypertension due to bile duct ligation, and in unoperated normal rats. 2. Portal venous pressure was higher in both groups of portal hypertensive rats than in normal rats. Cardiac output was significantly higher in portal hypertensive rats than in normal rats. 3. In rats with portal vein stenosis, splanchnic blood flow was higher than in controls. This increase was caused by increased perfusion of all organs drained by the portal vein, and by increased hepatic arterial blood flow. In rats with bile duct ligation, splanchnic blood flow was not significantly higher than in normal rats: haemoperfusion of all organs contributing to the portal circulation decreased, whereas hepatic arterial blood flow increased. As cardiac output rose similarly, the differences observed between the two types of portal hypertension depend mainly on the difference in distribution of flow within the splanchnic bed.

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