Lesão de isquemia e reperfusão hepáticas em cães: estudos histológicos sobre necrose hepatocítica, conteúdo de glicogênio hepático e contagem tecidual de polimorfonucleares

Hepatic ischaemia and reperfusion lesion in the dog: investigations of hepatocellular necrosis, hepatic glycogen content and polymorphonuclear tissue cells counting

ARTIGOS ORIGINAIS

Lesão de isquemia e reperfusão hepáticas em cães. Estudos histológicos sobre necrose hepatocítica, conteúdo de glicogênio hepático e contagem tecidual de polimorfonucleares

Hepatic ischaemia and reperfusion lesion in the dog. Investigations of hepatocellular necrosis, hepatic glycogen content and polymorphonuclear tissue cells counting

Renato Dornelas Câmara Neto, TCBC-PE^I; Silvia Limongi Lopes^II; Antônio Roberto de Barros Coelho^I; Ayrton Ponce de Souza, TCBC-PE^III; Álvaro Antônio Bandeira Ferraz, TCBC-PE^I; Edmundo Machado Ferraz, TCBC-PE^IV

^IProfessor Adjunto, Doutor do Departamento de Cirurgia do Centro de Ciências da Saúde, Hospital das Clínicas - UFPE

^IIProfessor Adjunto, Doutor do Departamento de Patologia do Centro de Ciências da Saúde da UFPE

^IIIProfessor dos Cursos de P6s-Graduação em Cirurgia, Doutor, Livre-Docente do Departamento de Cirurgia do Centro de Ciências da Saúde do Hospital das Clínicas - UFPE

^IVProfessor Titular, Doutor, Livre-Docente do Deptartamento de Cirurgia do Centro de Ciências da Saúde do Hospital das Clínicas da UFPE

^{Endereço para correspondência}

RESUMO

No transplante hepático, a fisiopatologia da lesão de isquemia e reperfusão do fígado não é completamente conhecida. Várias preparações experimentais têm sido usadas para estudos de tal lesão. Para tal fim, no presente trabalho, um modelo modificado foi proposto e avaliado. Vinte cães mestiços, pesando 15,25 ± 1,21 kg, sob anestesia geral, foram distribuídos em dois grupos de investigação: 1. Grupo Teste (n = 10) - os animais foram submetidos a desvascularização de 70% da massa hepática, por período de noventa minutos, seguida de revascularização do fígado. Durante o período de isquemia, a descompressão venosa esplâncnica foi realizada através dos lobos caudado e lateral direito; 2. Grupo Controle (n = 10) - os cães foram submetidos a operação simulada. Em todos os animais foram realizadas biópsias do fígado. O método foi avaliado através de determinações de Necrose Hepatocítica (NH), Conteúdo de Glicogênio Hepático (CGH) e Contagem Tecidual de Polimorfonucleares (CTPMN), realizadas aos cinco minutos antes da isquemia (T_o) cinco minutos antes da reperfusão (T₁) e uma hora (T₂) e cinco horas (T₃) após a reperfusão. Os resultados permitiram concluir com uma confiança de 95% que: I. Houve aumento progressivo de intensidade de NH e diminuição do CGH durante os estágios de isquemia e de reperfusão hepáticas; 2. Não foi comprovada diferença significativa na CTPMN entre os grupos investigados. As alterações histológicas verificadas são indicativas de NH efetiva, decorrente de isquemia e reperfusão do fígado.

Unitermos: Fígado; Isquemia normotérmica; Reperfusão; Necrose hepatocítica; Glicogênio hepático; Neutrófilos polimorfonucleares; Cães.

ABSTRACT

In the liver transplantation pathophysiology of hepatic ischaemia and reperfusion lesion is not completely understood. Several experimental models have been used to perform studies on tissue hipoxia and reperfusion of the liver. The present work, presents a modified model proposed to evaluate this kind of lesion. Twenty mongrel dogs, weighting 15.25 ± 1.21 kg, under general anesthesia, were referred to the following investigation groups: 1. Test Group (n = 10) - Animals were submitted to devascularization of 70 per cent of hepatic mass during a ninety minutes period, followed by liver reperfusion. During the time of ischaemia, splancnic venous decompression was provided through the right lateral and caudate lobes; 2. Control Group (n = 10) - The dogs were submitted to a sham operation. Liver samples were taken at 5 minutes before ischaemia (T₀) 5 minutes before reperfusion (T₁) and I hour (T₂) and 5 hours (T₃) after hepatic reperfusion. The method was evaluated by hepatic cells necrosis (HCN), hepatic glycogen content (HGC) and tissue polymorphonuclear cells counting (PMNCC). The results showed with a 95 per cent of confidence that: I. There was a progressive rise in HCN intensity and a fall in HGC, during the hepatic ischaemia and reperfusion stages; 2. There was no evidence of significant differences in PMNCC between the investigated groups. The verified histologic change are expression of effective HCN derived from liver isquemia and reperfusion.

Key words: Liver; Normothermic ischaemia; Reperfusion; Hepatic necrosis; Hepatic glycogen; Polymorphonuclear cells; Dogs.

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Recebido em 12/11/98

Aceito para publicação em 20/5/99

Trabalho realizado no Núcleo de Cirurgia Experimental do Depto. de Cirurgia do Centro de Ciências da Saúde e do Hospital das Clínicas da Universidade Federal de Pernambuco.

Endereço para correspondência:

Prof. Edmundo Machado Ferraz

Rua Dom Sebastião Leme, 173/2.501

52011-160 - Recife-PE

Datas de Publicação

• Publicação nesta coleção
  26 Jan 2010
• Data do Fascículo
  Jun 1999

Histórico

• Aceito
  20 Maio 1999
• Recebido
  12 Nov 1998