AIM: The study was designed to develop a readily reproducible model of acute liver failure (ALF) in the minipig, to gain an 8-hour therapeutic window to mimic, as closely as possible, acute liver failure in man. METHOD: We used reversible devascularization model of ALF in the minipig involving hepatic artery ligation and establish an end-to-side portocaval anastomosis. Standard laboratory monitoring was complemented with intracranial pressure (ICP) measurement. MATERIAL: Twenty minipigs (weight 25-30 kg) were used for the experiment. The animals were divided into 3 groups: I: 10 animals in an experimental group with ALF; II: 5 animals in an experimental group with ALF and ICP measurement, and III: 5 animals in a control group without ALF. RESULTS: Laboratory testing has shown the significant changes in levels of AST (33.44 +/- 39.96 vs. 1.56 +/- 0.50 mmol/l), lactate (2.97 +/- 1.16 vs. 1.18 +/- 0.61 mmol/l), and ammonia (264.3 +/- 93.05 vs. 42.5 +/- 12.98 mmol/l) between ALF groups and controls (p < 001) 6 h after the operative procedure, and significant changes in hypoglycemia and intracranial pressure were found 4 h after the operative procedure. The difference in Quick values (67.4 +/- 17.03 vs. 75.2 +/- 2.68) was not significant. We assume that the therapeutic window starts 4 h after the beginning of the experiment. CONCLUSION: Our devascularization model of ALF is simple and readily reproducible. The therapeutic window occurring shortly after surgery and persisting for a mean 9 h is suitable to evaluate bioartificial liver devices.

Transplant Surgery Department Institute for Clinical and Experimental Medicine Prague Czech Republic

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