Analyzing Liver Tissue Responses To Local Hemostatic Agents

Abstract

Objective – Our study aimed at evaluating changes in liver tissues after simulated injury and use of novel hemostatic agents (containing tranexamic acid) in the course of in vivo experiment. Material and Methods – The following hemostatic agents were studies: TachoComb collagen plate (Group 1); samples of novel local hemostatic agents based on sodium carboxymethyl cellulose (CMC), Na-CMC (Group 2); Na-CMC + tranexamic acid (Group 3). We performed the study on 30 rabbits with simulated liver laceration via laparoscopy, and were stopping bleeding by means of the above-mentioned methods. Then, on liver tissue micrographs, we were measuring capsule thickness (μm), sizes of hepatocytes and their nuclei (px), number of binuclear hepatocytes. We were also calculating nuclear-cytoplasmic ratio (NCR) of hepatocytes, as well as identifying qualitative and quantitative capsule composition in tested samples. Results – In the collagen plate group, the capsule width was 3.2-fold and 3.6-fold of this parameter in samples from Groups 2 and 3. Indirectly, this finding implied more severe inflammatory and regenerative processes aimed at limiting injury area, and was confirmed by statistically significant differences in the cellular composition of the capsule surrounding tested samples (fibroblastic cells predominated in Groups 2 and 3, and there were fewer of them in Group 1). The highest cell index (CI) value was detected in Group 3. Conclusion – A significant boundary zone separating tested materials from the liver parenchyma was also observed due to connective tissue growth as part of inflammatory response.