Name: rat model of the associating liver partition and portal vein ligation for staged hepatectomy (alpps) procedure
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Alle eksperimenter i denne protokol blev godkendt af veterinærmyndighederne i kantonen Zürich, Schweiz (nummer 60/2014). Desuden, alle eksperimenterende trin blev udført i nøje overensstemmelse med retningslinjerne for eksperimenter med dyr af schweiziske Academy i Medical Sciences (SAMS) og retningslinjer af den sammenslutning af europæiske laboratorium dyr videnskab foreninger (FELASA) .
1. dyrehold, Operating Room udstyr og instrumenter, anæstesi
<ol><li>Holde mandlige Wistar rotter...

<ol>
	<li>She, W. H., Chok, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Strategies+to+increase+the+resectability+of+hepatocellular+carcinoma.">Strategies to increase the resectability of hepatocellular carcinoma.</a> World J Hepatol. 7 (18), 2147-2154 (2015).</li><li>Vauthey, J. 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K., DeFrances, M. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Liver+regeneration.">Liver regeneration.</a> Science. 276 (5309), 60-66 (1997).</li><li>Fulop, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Alterations+in+hepatic+lobar+function+in+regenerating+rat+liver.">Alterations in hepatic lobar function in regenerating rat liver.</a> J Surg Res. 197 (2), 307-317 (2015).</li><li>Schnitzbauer, A. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Right+portal+vein+ligation+combined+with+in+situ+splitting+induces+rapid+left+lateral+liver+lobe+hypertrophy+enabling+2-staged+extended+right+hepatic+resection+in+small-for-size+settings.">Right portal vein ligation combined with in situ splitting induces rapid left lateral liver lobe hypertrophy enabling 2-staged extended right hepatic resection in small-for-size settings.</a> Ann Surg. 255 (3), 405-414 (2012).</li><li>de Santibanes, E., Clavien, P. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Playing+Play-Doh+to+prevent+postoperative+liver+failure:+the+&amp;#34;ALPPS&amp;#34;+approach.">Playing Play-Doh to prevent postoperative liver failure: the &amp;#34;ALPPS&amp;#34; approach.</a> Ann Surg. 255 (3), 415-417 (2012).</li><li>Schadde, E., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Monosegment+ALPPS+hepatectomy:+extending+resectability+by+rapid+hypertrophy.">Monosegment ALPPS hepatectomy: extending resectability by rapid hypertrophy.</a> Surgery. 157 (4), 676-689 (2015).</li><li>Dokmak, S., Belghiti, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Which+limits+to+the+&amp;#34;ALPPS&amp;#34;+approach?.">Which limits to the &amp;#34;ALPPS&amp;#34; approach?.</a> Ann Surg. 256 (3), e6 (2012).</li><li>Aloia, T. A., Vauthey, J. N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Associating+liver+partition+and+portal+vein+ligation+for+staged+hepatectomy+(ALPPS):+what+is+gained+and+what+is+lost?.">Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS): what is gained and what is lost?.</a> Ann Surg. 256 (3), e9 (2012).</li><li>Yao, L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Establishment+of+a+rat+model+of+portal+vein+ligation+combined+with+in+situ+splitting.">Establishment of a rat model of portal vein ligation combined with in situ splitting.</a> PLoS One. 9 (8), e105511 (2014).</li><li>Schlegel, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=ALPPS:+from+human+to+mice+highlighting+accelerated+and+novel+mechanisms+of+liver+regeneration.">ALPPS: from human to mice highlighting accelerated and novel mechanisms of liver regeneration.</a> Ann Surg. 260 (5), 839-846 (2014).</li><li>Croome, K. P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Characterization+of+a+porcine+model+for+associating+liver+partition+and+portal+vein+ligation+for+a+staged+hepatectomy.">Characterization of a porcine model for associating liver partition and portal vein ligation for a staged hepatectomy.</a> HPB (Oxford). 17 (12), 1130-1136 (2015).</li><li>Schadde, E., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Hypoxia+of+the+growing+liver+accelerates+regeneration.">Hypoxia of the growing liver accelerates regeneration.</a> Surgery. 161 (3), 666-679 (2017).</li><li>Moris, D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Mechanistic+insights+of+rapid+liver+regeneration+after+associating+liver+partition+and+portal+vein+ligation+for+stage+hepatectomy.">Mechanistic insights of rapid liver regeneration after associating liver partition and portal vein ligation for stage hepatectomy.</a> World J Gastroenterol. 22 (33), 7613-7624 (2016).</li><li>Garcia-Perez, R., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Associated+Liver+Partition+and+Portal+Vein+Ligation+(ALPPS)+vs+Selective+Portal+Vein+Ligation+(PVL)+for+Staged+Hepatectomy+in+a+Rat+Model.+Similar+Regenerative+Response?.">Associated Liver Partition and Portal Vein Ligation (ALPPS) vs Selective Portal Vein Ligation (PVL) for Staged Hepatectomy in a Rat Model. Similar Regenerative Response?.</a> PLoS One. 10 (12), e0144096 (2015).</li><li>Shi, H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+preliminary+study+of+ALPPS+procedure+in+a+rat+model.">A preliminary study of ALPPS procedure in a rat model.</a> Sci Rep. 5, 17567 (2015).</li><li>Almau Trenard, H. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Development+of+an+experimental+model+of+portal+vein+ligation+associated+with+parenchymal+transection+(ALPPS)+in+rats.">Development of an experimental model of portal vein ligation associated with parenchymal transection (ALPPS) in rats.</a> Cir Esp. 92 (10), 676-681 (2014).</li><li>Dhar, D. K., Mohammad, G. H., Vyas, S., Broering, D. C., Malago, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+novel+rat+model+of+liver+regeneration:+possible+role+of+cytokine+induced+neutrophil+chemoattractant-1+in+augmented+liver+regeneration.">A novel rat model of liver regeneration: possible role of cytokine induced neutrophil chemoattractant-1 in augmented liver regeneration.</a> Ann Surg Innov Res. 9, 11 (2015).</li><li>Wei, W., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Establishment+of+a+rat+model:+Associating+liver+partition+with+portal+vein+ligation+for+staged+hepatectomy.">Establishment of a rat model: Associating liver partition with portal vein ligation for staged hepatectomy.</a> Surgery. 159 (5), 1299-1307 (2016).</li><li>Tschuor, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Salvage+parenchymal+liver+transection+for+patients+with+insufficient+volume+increase+after+portal+vein+occlusion+-+an+extension+of+the+ALPPS+approach.">Salvage parenchymal liver transection for patients with insufficient volume increase after portal vein occlusion - an extension of the ALPPS approach.</a> Eur J Surg Oncol. 39 (11), 1230-1235 (2013).</li><li>Schadde, E., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Early+survival+and+safety+of+ALPPS:+first+report+of+the+International+ALPPS+Registry.">Early survival and safety of ALPPS: first report of the International ALPPS Registry.</a> Ann Surg. 260 (5), 829-836 (2014).</li><li>Harnoss, J. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Prolyl+Hydroxylase+Inhibition+Enhances+Liver+Regeneration+Without+Induction+of+Tumor+Growth.">Prolyl Hydroxylase Inhibition Enhances Liver Regeneration Without Induction of Tumor Growth.</a> Ann Surg. , (2016).</li><li>Olthof, P. B., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Comparable+liver+function+and+volume+increase+after+portal+vein+embolization+in+rabbits+and+humans.">Comparable liver function and volume increase after portal vein embolization in rabbits and humans.</a> Surgery. 161 (3), 658-665 (2017).</li><li>Olthof, P. B., van Gulik, T. M., Bennink, R. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Optimal+use+of+hepatobiliary+scintigraphy+before+liver+resection.">Optimal use of hepatobiliary scintigraphy before liver resection.</a> HPB (Oxford). 18 (10), 870 (2016).</li><li>Lau, L., Christophi, C., Muralidharan, V. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intraoperative+functional+liver+remnant+assessment+with+indocyanine+green+clearance:+another+toehold+for+climbing+the+&amp;#34;ALPPS&amp;#34;.">Intraoperative functional liver remnant assessment with indocyanine green clearance: another toehold for climbing the &amp;#34;ALPPS&amp;#34;.</a> Ann Surg. 261 (2), e43-e45 (2015).</li><li>Cieslak, K. P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Assessment+of+Liver+Function+Using+(99m)Tc-Mebrofenin+Hepatobiliary+Scintigraphy+in+ALPPS+(Associating+Liver+Partition+and+Portal+Vein+Ligation+for+Staged+Hepatectomy).">Assessment of Liver Function Using (99m)Tc-Mebrofenin Hepatobiliary Scintigraphy in ALPPS (Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy).</a> Case Rep Gastroenterol. 9 (3), 353-360 (2015).</li><li>Truant, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Drop+of+Total+Liver+Function+in+the+Interstages+of+the+New+Associating+Liver+Partition+and+Portal+Vein+Ligation+for+Staged+Hepatectomy+Technique:+Analysis+of+the+&amp;#34;Auxiliary+Liver&amp;#34;+by+HIDA+Scintigraphy.">Drop of Total Liver Function in the Interstages of the New Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy Technique: Analysis of the &amp;#34;Auxiliary Liver&amp;#34; by HIDA Scintigraphy.</a> Ann Surg. 263 (3), e33-e34 (2016).</li></ol>

Denne protokol udgør en dyremodel af ALPPS med sit hurtige hypertrofi induceret af PVL + T, der groft fordobler volumen stigning inden for 3 dage sammenlignet med PVL alene. 17 den højre midterste hepatisk lap er brugt som en model for den voksende lever lap fordi den midterste hepatiske lap er én sammenhængende parenkymalt masse leveres af to separate portal vener til venstre og til højre side, som vist i figur 1 i en nylig offentliggjort arbejde. <sup class="xr...

Størrelsen af den lever rest begrænser resectability af levertumorer. 1 i generelle, når mindre end 25% leveren væv er efterladt, patienten er i øget risiko for at dø af akut leversvigt på grund af manglende metabolisk funktion for hele organismen ("alt for lille for størrelsen syndrom"). 2 denne post-hepatectomy leversvigt er den mest ødelæggende komplikation efter lever resektion. Klinikere har derfor forsøgt at fremkalde lever regenerering inden resektion af leveren ved at manipulere med strømmen af portalen vene. 3 det blev konstateret, at når portalen vene er tilstoppet, den resterende del med portalen vene flow begynder at vokse i et langsomt tempo, og kan dermed øge op til 60% i størrelse. 4 kirurgisk ligatur5 eller interventionel portal vene okklusion har begge været klinisk er etableret. 4 stigning i volumen og funktion af leveren er pålidelige, men væksten i leveren efter portal okklusion er kun omkring en femtedel i forhold til væksten i rest leveren efter delvis hepatectomy. 6
Den nødvendige tid til leveren til at vokse er uger til måneder, selv om leveren kan regenerere i en meget hurtigere tempo efter resektion. Leveren er det eneste organ, der vokser tilbage til normal funktion efter fjernelse af en del af det. 7 en roman procedure inducerende lever regenerering i samme tempo som efter delvis hepactectomy blev udviklet af en gruppe af kirurger der opdagede, at tilføje en transection mellem den tilstoppet og den ikke-tilstoppet del af leveren inducerer leveren Hjertehypertrofi med samme vækst sats som efter lever resektion, men før resektion. 9 proceduren, der initierer hurtige hypertrofi af 80% inden for en uge i fremtiden lever rest, der giver mulighed for resektion af omfattende, primært inoperabel, lever tumorer inden for en uge. Proceduren blev kaldt "Associating leveren Partition og Portal vene ligatur for stadieinddelte hepatectomy = ALPPS" og blev hurtigt populære i hele verden. 10 flere betænkninger støttet en udvidelse af resectability af borderline resektable levertumorer opnås ved den nye teknik,11 mens den komplekse kirurgiske procedure blev også kritiseret for sin høje komplikation sats. 12 , 13
Udviklingen af en gnaver og også store dyremodeller for langsomme og hurtige hypertrofi har forsøgt siden offentliggørelsen af ALPPS i 2012 til at tillade en bedre histologiske karakterisering og forståelse af mekanismerne og teste narkotika virkninger på den forskellige vækstrater i levervævet i dyr. De første dyr model udviklet var en rotte model. I denne model, hurtig hypertrofi efter parenkymalt transection mellem højre og venstre del af den mediane lap accelereret regenerering af lige median lap. 14 en anden model blev introduceret senere i musen. I denne model venstre laterale lap var resektion og portal vene grene til hver lap af leveren undtagen venstre median lap blev bundet. 15 i mellemtiden stort dyremodeller for ALPPS hos svin er blevet beskrevet så godt. 16
Til undersøgelse af fysiologiske mekanismer som flow ændringer og presset i portalen vene, perfusion og iltning af levervævet er rotte model overlegen i forhold til model af ALPPS i mus. En anden fordel ved rotten modellen for murine er rotte model der er ingen nødvendighed for en resektion af den venstre laterale lap,15 , som kan forurene virkningerne af leveren resektion med dem af ALPPS. Rotte model derimod ikke reducere leveren celle masse. En gris model bruger den højre bageste lap som den voksende lap, men grisen leveren er yderst lobulated. Derfor er det vanskeligt at oprette et transection fly i den allerede tynde væv bro mellem den højre bageste og den højre forreste lap. I modsætning hertil den mediane lap i rotter består af to dele, der leveres separat af en portal vene hver og en parenkymalt transection fly kan nemt blive skabt mellem de to ved hjælp af microsurgical teknikker. Tilgængeligheden af små dyr computertomografi (CT) og/eller magnet resonans imaging (MR) tillader meget nøjagtig kvantificering af volumetriske vækst mellem Vena ligatur alene og portal vene ligatur og den ekstra transection, som er vigtige til validering af alle hurtige lever hypertrofi model.
Protokollen præsenteres her beskrives den kirurgiske teknik og metoder til volumetriske validering og fysiologisk karakterisering af modellen for langsomme og hurtige hypertrofi efter portåren ligatur og portal vene ligatur med transection, henholdsvis i rotter.

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			<td height="21" style="height:21px;width:225px;">Isoflurane, 250ml bottles</td>
			<td style="width:400px;">Attane, Piramal, Mumbai, India</td>
			<td style="width:255px;">LDNI 22098</td>
			<td style="width:340px;">Standard vet. equipment</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">Tec-3 Isofluorane Vaporizer</td>
			<td>Ohmeda, GE-Healthcare, Chicago, IL</td>
			<td>not available anymore</td>
			<td>Standard vet. equipment&#160;</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">Buprenorphine (Temgesic)</td>
			<td>Indivior, Baar, Switzerland</td>
			<td>7680419310353</td>
			<td>GTIN-number</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">Vitamine A ointment</td>
			<td>Bausch&#38;Lomp, Zug, Switzerland</td>
			<td>7680223980247</td>
			<td>GTIN-number</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">Atropine sulfate 0.5mg/ml</td>
			<td>Sintetica SA, Mendrisio, Switzerland</td>
			<td>7680565330045</td>
			<td>GTIN-number</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">Microsurgery microscope</td>
			<td>Olympus, Tokio, Japan</td>
			<td>SZX10</td>
			<td>Standard vet. equipment</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">Betadine</td>
			<td>Mundipharma, Basel, Switzerland</td>
			<td>7680342821377</td>
			<td>GTIN-number</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">Sponges</td>
			<td>Carl Roth GmbH, Karlsruhe, Germany</td>
			<td>NK83.1</td>
			<td>Mini-sponges</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">Abdominal Wall retractors</td>
			<td>N/A</td>
			<td>N/A</td>
			<td>Self-made from paper clips and Q-Tips</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">3-0 silk&#160;</td>
			<td>Ethicon, Sommerville, NJ</td>
			<td>K872H</td>
			<td>Standard surgical</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">Scissors&#160;</td>
			<td>World precision instruments (WPI), Sarasota, FL</td>
			<td>503371</td>
			<td>Standard microsurgical</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">Adson forceps</td>
			<td>World precision instruments (WPI), Sarasota, FL</td>
			<td>501244-G</td>
			<td>Standard microsurgical</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">Fine tips microforceps</td>
			<td>World precision instruments (WPI), Sarasota, FL</td>
			<td>501976</td>
			<td>Tips need to be polished regularly</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">Curved fine tips microforceps</td>
			<td>World precision instruments (WPI), Sarasota, FL</td>
			<td>504513</td>
			<td>Essential to go around the portal vein branches&#160;</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">6-0 LOOK black braided silk</td>
			<td>Surgical Specalities Corporation, Wyomissing, PA&#160;</td>
			<td>SP114</td>
			<td>Spool, precut prior to the procedure</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">2-0 silk sutures</td>
			<td>Ethicon, Sommerville, NJ</td>
			<td>K833</td>
			<td>Standard surgical</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">5-0 maxon sutures</td>
			<td>Covidien, Dublin, Ireland</td>
			<td>6608-21</td>
			<td>Standard surgical</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">Bipolar microforceps</td>
			<td>Sutter, Freiburg, Germany</td>
			<td>780148SGS</td>
			<td>Essential for parenchymal transection</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">Q-tips small</td>
			<td>Carl Roth GmbH, Karlsruhe, Germany</td>
			<td>EH11.1</td>
			<td>Standard surgical</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">Q-tips big</td>
			<td>Carl Roth GmbH, Karlsruhe, Germany</td>
			<td>XL54.1</td>
			<td>Standard surgical</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">G30 needle&#160;</td>
			<td>Terumo, Tokyo, Japan</td>
			<td>NN-3013R&#160;</td>
			<td>Standard anesthesia equipment</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">2mm volume flow probe&#160;</td>
			<td>Transonic Systems, Ithaca, NY</td>
			<td>MA-2PS</td>
			<td>Smallest available probe for HAT-311 flow meter</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">Transonic flow meter</td>
			<td>Transonic Systems, Ithaca, NY</td>
			<td>HAT-311 Transsonic flow QC meter</td>
			<td>One of the&#160; first generation flow flow meters for surgery</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">ExiTron nano 12,000&#160;</td>
			<td>Miltenyi Biotech, Bergisch Gladbach, Germany</td>
			<td>130-095-698</td>
			<td>Nanomoloecular contrast medium that opacifies liver and spleen</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">G26 intravenous catheter</td>
			<td>Becton Dickinson, Franklin Lakes, NJ</td>
			<td>391349</td>
			<td>Standard anesthesia equipment</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">Quantum FX MicroCT&#160;</td>
			<td>Perkin Elmer, Waltham, MA</td>
			<td>N/A</td>
			<td>Standard small animal CT scanner at the institute of physiology, University of Z&#252;rich</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">OsiriX 8.0</td>
			<td>Pixmeo Sarl, Geneva, Switzerland</td>
			<td>N/A</td>
			<td>Public domain software : www.pixmeo.com</td>
		</tr>
	</tbody>
</table>

rat model of the associating liver partition and portal vein ligation for staged hepatectomy (alpps) procedure

Nylige kliniske data støtter en aggressiv kirurgisk tilgang til både primær og metastatisk levertumorer. For nogle indikationer, som kolorektal lever metastaser, efterladt mængden af levervævet, når leveren resektion er blevet den vigtigste begrænsende faktor for resectability af store eller flere levertumorer. En minimal mængde af funktionelle væv er forpligtet til at undgå de alvorlige komplikation af post-hepatectomy leversvigt, som har høj sygelighed og dødelighed. Inducerende lever vækst af den potentielle rest før resektion er blevet mere etableret i leveren kirurgi, enten i form af portalen vene embolisering af Interventionel radiologer eller i form af portalen vene ligatur flere uger før resektion. For nylig, det blev påvist, at leveren regenerering er mere omfattende og hurtigere, når den parenkymalt transection føjes til portalen vene ligatur i første omgang og derefter, efter kun en uge venter, resektion udført i en anden fase (knytte leveren Partition og Portal vene ligatur for stadieinddelte hepatectomy = ALPPS). ALPPS er hurtigt blevet populært over hele verden, men er blevet kritiseret for sin høje perioperative dødelighed. Mekanismen for hurtig og omfattende vækst induceret af denne procedure er ikke blevet godt forstået. Dyremodeller har udviklet for at udforske både fysiologiske og molekylære mekanismer af accelereret lever regenerering i ALPPS. Denne protokol udgør en rotte model, der giver mulighed for mekanistisk udforskning af accelereret regenerering.

To forskellige kirurgiske procedurer portåren ligatur (PVL) og PVL med transection (PVL + T) resultere i udpræget forskellige vækst kinetik. PVL inducerer moderat lydstyrke stigning inden for 3 dage, hvorimod i PVL + T en meget større lige median lap (RML) kan være set (figur 5). Dette kan verificeres af daglige volumetry. Omfanget af RML ca fordobler inden for 3 dage i PVL, mens det tredobler i PVL + T.17
<p class="jove_conte...

Watch this Scientific Journal Video about Rat Model of the Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy ALPPS Procedure at JoVE.com

Rat Model of the Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy ALPPS Procedure

Inducerende hurtige lever hypertrofi ved hjælp af knytte leveren Partition og Portal vene ligatur for en stadieinddelte hepatectomy er (ALPPS) blevet foreslået for resektion af borderline resektable levertumorer. Denne model kan belyse mekanismer involveret i hurtige hypertrofi og tillader test af lægemidler, der fremmer eller blokere acceleration af regenerering.

Rotte Model af inddrage fiskelever Partition og Portal vene ligatur procedure, iscenesatte Hepatectomy (ALPPS)

Recent clinical data support an aggressive surgical approach to both primary and metastatic liver tumors. For some indications, like colorectal liver ...

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Rat Model of the Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy (ALPPS) Procedure

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3-dimensionelt Resin Støbning og Imaging of Mouse Portal Vein eller Intrahepatisk galdegang System

In  organs, the correct architecture of vascular and ductal structures is  indispensable for proper physiological function, and the formation and  ...

Surgical Procedures for a Rat Model of Partial Orthotopic Liver Transplantation with Hepatic Arterial Reconstruction

Kirurgiske procedurer for en rottemodel af partiel ortotopisk levertransplantation med hepatisk arteriel Genopbygning

Orthotopic liver transplantation (OLT) in rats using a whole or partial graft is an indispensable experimental model for transplantation research, such as ...

Heterotopic Auxiliary Rat Liver Transplantation With Flow-regulated Portal Vein Arterialization in Acute Hepatic Failure

Heterotop Auxiliary Rat levertransplanterede patienter med Flow-regulerede portåren Arterialization i akut leversvigt

In acute hepatic failure auxiliary liver transplantation is an interesting alternative approach. The aim is to provide a temporary support until the ...

The Dimethylnitrosamine Induced Liver Fibrosis Model in the Rat

Den dimethylnitrosamin induceret leverfibrose Model i Rat

Four to six week old, male Wistar rats were used to produce animal models of liver fibrosis. The process requires four weeks of administration of 10 mg/kg ...

Method of Direct Segmental Intra-hepatic Delivery Using a Rat Liver Hilar Clamp Model

Metode til direkte Segmentoplysninger Intra-hepatisk Levering Ved hjælp af en rotte Lever hilar Clamp Model

Major hepatic surgery with inflow occlusion, and liver transplantation, necessitate a period of warm ischemia, and a period of reperfusion leading to ...

Re-Arterialized Rat Partial Liver Transplantation with an in vivo Vessel-Oriented 70% Hepatectomy

Re-Arterialized Rat Partial Liver Transplantation with an in vivo Vessel-Oriented 70% Hepatectomy

Re Arterialized rotte delvis lever Transplantation med en i vivo fartøj-orienterede 70% Hepatectomy

Split liver transplantation and living liver donor liver transplantation were developed in the clinic to utilize liver organs in a more efficient manner. ...

Generation of a Rat Model of Acute Liver Failure by Combining 70% Partial Hepatectomy and Acetaminophen

Generation af en rotte model af akut leversvigt ved at kombinere 70% partiel Hepatektomi og acetaminophen

Acute liver failure (ALF) is a clinical condition caused by various etiologies resulting in the loss of metabolic, biochemical, synthesizing, and ...

Organ Ischemia-Reperfusion Injury by Simulating Hemodynamic Changes in Rat Liver Transplant Model

Organ Iskæmi-Reperfusion Skade ved at simulere hæmodynamiske ændringer i rottelevertransplantation Model

Orthotopic liver transplantation (OLT) in rats is a tried and proven animal model used for preoperative, intraoperative, and postoperative studies, ...

Repetitive Blood Sampling from the Subclavian Vein of Conscious Rat

Gentagen blodprøvetagning fra den subklaviske vene hos bevidst rotte

Rats are widely used in pharmacokinetics (PK) and toxicokinetic (TK) studies that need to collect a certain amount of blood at specific time points to ...