https://openworks.mdanderson.org/sumexp23/1047/thumbnail.jp

Barcena, Allan John R.

Bernardino, Marvin R.

Huang, Steven Y.

Lin, Vincent

Melancon, Marites P.

Mishra, Archana

San Valentin, Erin Marie D.

English

OpenWorks @ MD Anderson

The increase in liver growth with MSCs is significant due to the baseline FLR size needed for life saving surgery to be performed. Some patients may suffer from conditions such as mild cirrhosis or have had major chemotherapy exposure, causing the percentage of liver remnant volume needed for surgery to increase drastically. The increased liver growth caused by MSCs allow for a safe surgery and recovery post operation.This experiment sets up baseline data for future experiments on liver growth and regeneration.Introduction• What is PVL/PVE?:Portal Vein Embolization (PVE) or PortalVein Ligation (PVL) is a technique used toincrease the volume of functional liverbefore surgery. Portal blood flow isredirected to the future liver remnant(FLR), initiating hypertrophy in the FLR.•Why are MSCs used as anadjunct?Stem cells have been shown toparticipate in liver regeneration. The useof MSCs as an adjunct with PVE allowsfor significantly higher FLR growth thanwhen not in use.• MSC culture:Bone-marrow derived Sprague-Dawley ratmesenchymal stem cells (MSCs) labeledwith a red fluorescent protein (RFP) werecultured in DMEM with 10% FBS and 1% Pen-Strep. .• Portal vein ligation/injection:In a Sprague-Dawley rat model, portal veinbranches for the left and middle lobes wereligated. MSCs were then injected into thenon- occluded (right) portal vein branches.• CT imaging for volume estimation:CT imaging was performed on a 128-slice CT scanner (Somatom DefinitionEdge, Siemens Healthineers) availableat the Dunn Laboratory. Quantification ofliver volume was done using MIM7.1.4software•Necropsy and histology:Results and DiscussionConclusionPre-operative portal vein ligation and MSC injection in a rat modelVincent Lin1,2, Allan John R. Barcena2, Marvin R. Bernardino2, Archana Mishra2, Erin Marie D. San Valentin2, Steven Y. Huang2, Marites P. Melancon21Bellaire High School, 2Department of Interventional Radiology, The University of Texas MD Anderson Cancer CenterWeek 0 Control PVL PVL+MSCWhole 3.15 ml 4.31 ml 4.96 mlLeft 2.10 ml 2.96 ml 3.15 mlRight 1.05 ml 1.35 ml 1.81 mlFLR/Total Ratio 0.33 0.31 0.36Liver Control PVL PVL+MSCLeft 5.2120 g 2.2039 g 1.3277 gRight 2.5480 g 4.2783 g 5.6780 gTotal 7.7600 g 6.4822 g 7.0057 gFLR/Total Ratio 0.33 0.66 0.81Methods and MaterialsFig. 3. CT imaging of the rat model livers. The scans indicate a significant increase in volume proportion of the non-ligated lobes when MSCs are in use.Fig. 2. MSCs marked with a red fluorescent protein. Control PVL PVL+ MSCLeft RightFigure 4. Necropsy of the ligated (left & middle) and non-ligated (right & caudate) liver lobes. (A) Photographs of the collected liver samples. (B) Quantification of the showed that the ligation + MSC-treated group had the highest FLR (right & caudate) to total weight ratio.AFig. 1. Diagram showing the different lobes of the liver and the branches of the portal veinBControl PVL PVL+MSCWeek 0Week 2Table 1. Liver volume estimations calculated using MIM7.1.4Table 2. Liver weights of the three rats at 2 weeks10x 20x• The data from our experiment clearly shows that MSCs are effective in increasing the FLR/Total weight ratio (≈70% increase) when used in conjunction with PVL, compared to the PVL only group (≈40% increase), as shown in Table 2.• The correlation between the right to total liver ratios for the liver volumes estimated through the CT scans, and the liver weights, shows that CT scans are a viable option for determining the size of a patient’s liverReferencesThe rats were sacrificed after 2 weeks, and the livers lobes were harvested and weighed.The liver samples were fixed in 10%buffered formalin, paraffin-embedded,and sectioned at 4 µm. The slides werestained for RFP, our MSC marker. • Vyas et al. Portal vein embolization and ligation for extended hepatectomy. Indian J Surg Oncol. 2014 Mar;5(1):30-42. doi: 10.1007/s13193-013-0279-y. 4x 20xControlPVLPVL+MSCFig.5. Histology. Liver samples were stained for the RFP and showed the presence of MSCs within the liver of the PVL+MSC rat. Week 2 Control PVL PVL+MSCWhole 4.34 ml 3.08 ml 4.62 mlLeft 2.99 ml 1.17 ml 1.54 mlRight 1.35 ml 1.91 ml 3.08 mlFLR/Total Ratio 0.31 0.62 0.67•CT Volumes vs WeightsTwo methods were utilized to determine liver size, CT scans to estimate liver volume, and the liver weights taken after the rats are sacrificed.

Pre-operative portal vein ligation and MSC injection in a rat model

https://openworks.mdanderson.org/cgi/viewcontent.cgi?article=1047&context=sumexp23

Pre-operative portal vein ligation and MSC injection in a rat model

Abstract

Similar works

Full text

Available Versions

OpenWorks @ MD Anderson