A Long Term Comparison Study: Liver Fibrosis By Microcapsules Transplantation Via Different Path

Objective::To compare the liver fibrosis induced by different quantity microcapsules transplantation via portal vein and hepatic artery.Methods:Twenty dogs in this experiment were divided randomly into four groups:group V1,groupV2(microcapsules implanted into portal vein by percutaneous transhepatic approach guided by ultrasound)and group A1,groupA2(microcapsules implanted into hepatic artery by hepatic artery catheterization).The quantity of microcapsules implanted with group A1 and group A2 were 32000/Kg and 48000/Kg respectively. the quantity of microcapsules implanted with group V1 were 16000/Kg,and group V2 were 32000/Kg.blood flow rate and diameter of the port vein were examined by ultrasound before and 1 week,6 weeks,12 weeks,24weeks,36weeks,48 weeks after the operation.ALT,AST and the main serum liver fibrosis indexes were measured before and after the transplantation.Samples of the livers were examined pathologically before and 6 weeks,12 weeks,24 weeks,36 weeks,48 week after the operation.Perfusion MR imaging of the liver were detected before and 12 weeks,24 weeks,36 weeks,48 week after the operation.Results The chang of blood flow rate with main port vein in every group were not significant after one week postoperation(P＞0.05).Blood flow rate with main port vein in group A1 and A2 didn't chang,but decreased vicious in group V1 and V2 duing the operation.Serum liver fibrosis indexes HA in every group elevated gradually after operation,and decreased after twelve weeks postoperation.CⅣin every group elevated gradually afer the operation.HA,CⅣelevated more with more microcapsules in the same pathway.HA,CⅣelevated more transplantated by port vei than by hepatic artery with the same quantity.The difference between groups was significant(P＜0.05).The elevation in group V2 was the highest,and in group A1 was lightest.The ALT and AST of all dogs increased variously after transplantation.They reached the top 24 hours after the operation,and decreased then.The ALT and AST increased highest in group V2,least in group A1.ALT,AST elevated more with more microcapsules in the same pathway,and elevated more transplantated by port vei than by hepatic artery with the same quantity.The difference between every group was significant(P＜0.01).The time to peak(TP) of regions of interested(ROI) and main port vein was detected before and after the operation.TP of the same ROI extensed 6 weeks after the operation in every group,then declined gradually,the extension in Group V2 was the most.48 weeks after operation,TP of each group closed to the level before operation.The chang of TP between group were not significant(P＞0.05).Differences inside group were significant(P＜0.01),The TP margin with ROI and main port vein did not change significantly in group A1and A2.The TP margin with ROI and main port vein decreased in group V1 and V2, Group V2 was more significantly.The TP margin between group had a significant difference(P＜0.05).Microcapsules could be seen in hepatic artery branch,portal branch and liver sinus in histopathology slice.In group V2,some pathogenic changes of liver were found in the hepatic sections after 24 weeks' post-transplant,the structure of lobule is abnormal,showing degeneration and some liver fibrosis.In group A1,no obvious pathogenic changes were found at 48 weeks' post-transplant.In group A2 and group V1, degeneration with liver were found.24 weeks after transplantation,liver examination found a small amount of collagen deposition with the District and liver cells cloudy swelling in Group V2,hyperplasia of collagen fibers with district was apparent 48 weeks after the operation. The liver had no obvious abnormality in group A1 after operation;A2 group that some Turbidimetry swollen liver cells could be found in group A2,but no significant fiber hyperplasia.ConclusionLarge dose microcapsules transplanted by portal vein could cause damage to the liver,the quantity reached 32,000/Kg can result in long-term liver fibrosis.Microcapsules transplanted by hepatic artery damaged smaller, transplantation amounted to 48,000/Kg did not see significant liver fibrosis.The hepatic artery is expected to be a more secure means of transplantation.