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Acute Limb Ischemia Caused by Femoral Arterial Line Induces Remote Liver Injury in a Rabbit Model of Liver Ischemia/Reperfusion Injury

HPB and Liver Transplant Unit, Department of Surgery, School of Medicine, University of Ioannina, Greece, gglantzounis{at}gmail.com, HPB and Liver Transplant Unit, University Department of Surgery, School of Medicine, University of Ioannina, Greece

Hemant Sheth, MD

HPB and Liver Transplant Unit, University Department of Surgery, School of Medicine, University of Ioannina, Greece

Cecil Thompson, PhD

Department of Clinical Biochemistry Royal Free Hospital, Royal Free and University College Medical School, University College London, London, United Kingdom

Tariq S. Hafez, MD

HPB and Liver Transplant Unit, University Department of Surgery, School of Medicine, University of Ioannina, Greece

Sanjeev Kanoria, MD

HPB and Liver Transplant Unit, University Department of Surgery, School of Medicine, University of Ioannina, Greece

Viniyendra Pamecha, MD

HPB and Liver Transplant Unit, University Department of Surgery, School of Medicine, University of Ioannina, Greece

Susan Davies, MD

Department of Histopathology, Addenbrooke's Hospital, Cambridge, United Kingdom

Dimitri P. Mikhailidis, MD

Department of Clinical Biochemistry Royal Free Hospital, Royal Free and University College Medical School, University College London, London, United Kingdom

Alexander M. Seifalian, PhD

HPB and Liver Transplant Unit, University Department of SurgerySchool of Medicine, University of Ioannina, Greece

Brian R. Davidson, MD

HPB and Liver Transplant Unit, University Department of Surgery,

Femoral arterial lines are used for continuous monitoring of arterial blood pressure in experimental studies. However, placement of a catheter in the femoral artery could produce acute limb ischemia with associated systemic effects. The aim of this study was to investigate the effect of femoral arterial line insertion on liver function, in a rabbit liver lobar ischemia-reperfusion (I/R) model. Four groups of animals (n = 6 each) were studied: groups 1 and 2 (sham) underwent laparotomy but no liver ischemia. In groups 3 and 4 (I/R), liver lobar ischemia was induced for 60 minutes followed by 7 hours of reperfusion. In groups 1 and 3, the arterial line was placed in the femoral artery whereas in groups 2 and 4 in the ear artery. Liver function was assessed by serum alanine aminotransferase (ALT) activity, bile flow, plasma lactate levels, and histology. Results are expressed as mean ± SEM. Alanine aminotransferase activity and lactate levels were significantly higher in the I/R femoral line group compared with the I/R ear line group at 7 hours postreperfusion. Bile production was significantly lower (75 ± 9.6 vs 112 ± 10 µL/min per 100 g liver weight). Histopathology showed more extensive hepatocellular necrosis and neutrophil accumulation in the I/R femoral line group compared with I/R ear line group. The sham femoral group showed liver injury, which was more marked than the ear line group (all P < .05). In conclusion, femoral artery cannulation induces remote liver injury. The use of femoral arterial lines should be avoided in experimental studies concerning liver function.

Key Words: limb ischemia • experimental • hepatic • femoral arterial line • remote liver injury • ischemiareperfusion

This version was published on October 1, 2009

Angiology, Vol. 60, No. 5, 554-561 (2009)
DOI: 10.1177/0003319709338176


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