Purpose: Liver regeneration is crucial following major liver resection or partial liver transplantation. The inhibition mechanism of regeneration is portal hypertension caused by excessive portal flow to the small liver. Portal hypertension can be controlled with terlipressin, an effective splanchnic vasoconstrictor. The purpose of this study was to investigate the effect of terlipressin on the portal pressure and liver regeneration in 90% hepatectomized rats.
Methods: Forty-eight male Sprague-Dawley (250 gm) rats were divided into three groups; Group N (n=16) underwent Sham operation, Group C (n=16) was injected with 0.1 mL saline after 90% hepatectomy, and Group T (n=16) was injected with 50μg/kg terlipressin after 90% hepatectomy. To assess the liver regeneration response, the changes in proliferating cell nuclear antigen (PCNA) and tumor necrosis factor-alpha (TNFα) were monitored for 48 hours.
Results: The baseline portal pressures in Groups N, C, and T were 4.9, 12.4, and 14.1 mmHg (P＜0.05). In Group T, the injection of terlipressin induced a significant reduction of the portal pressure (-30.2%, P＜0.05). There was no difference in PCNA between Groups C and T. However, serum TNFα levels were significantly higher in Group T (248.4 pg/ mL) than Group C (52.3 pg/mL) 48 hours postoperatively (P＜0.05).
Conclusion: The control of portal pressure with the use of terlipressin was correlated with serum TNFα. These data provide evidence that the administration of terlipressin during the early postoperative period following major liver resection may have an attenuating effect on portal hypertension, which may also stimulate the initiation of the regenerative process. (J Korean Surg Soc 2005;69:157-165)
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