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Background: Radiofrequency ablation (RFA) is a minimal invasive therapeutic option for patients with hepatocellular carcinoma or liver metastases. We investigated RFA-induced cellular changes in the liver of pigs. Material and Methods: Healthy pigs (n=18) were sacrificed between day 0 and 3 months after RFA. The wound healing process was evaluated by computed tomography (CT), chromotrope anilinblue (CAB) staining of large-scale and standard tissue sections. Immunohistochemistry (IHC) for heat shock protein 70, Caspase-3, Ki67, Reelin, Vinculin, Vimentin and αSMA was perfomed. Results: One day after RFA, CAB staining showed cell damage and massive hyperaemia. All IHC markers were predominantly expressed at the outer borders of the lesion, except Reelin, which was mainly detected in untreated liver regions. By staining for Hsp70, the heat stress during RFA was monitored, which was most distinct 1-2 days after RFA. CT revealed decreased lesion size after one week. Development of a Vimentin and α-SMA positive fibrotic capsule was observed. Conclusion: In the early phase signs of cell damage, apoptosis and proliferation are dominant. Reduced expression of Reelin suggests a minor role of hepatic stellate cells in the RFA zone. After one week myofibroblasts become prominent and contribute to the development of the fibrotic capsule. This elucidates the pathophysiology of RFA and could contribute to the future optimization of RFA procedures.

Introduction: The reperfusion phase during orthotopic liver transplantation (LTX) is a critical event with sometimes profound hemodynamic and cardiac changes. We present the influence of retrograde reperfusion in LTX on the post-reperfusion syndrome (PRS). Methods: Fifty-six LTXs in 53 patients were performed with the piggy-back technique with retrograde reperfusion via the caval vein and antegrade reperfusion via the portal vein. The incidence of PRS was evaluated. Results: We observed a PRS in two patients (3.6%), four patients (7.1%) had a decrease in mean arterial pressure (MAP) of 20–29%, 18 patients (32.2%) of 10–19%, 27 patients (48.2%) of 1–9% and five patients (8.9%) had a small increase in MAP. Discussion: Our retrospective study showed that retrograde reperfusion seems to maintain stability during the reperfusion phase. Hemodynamic disturbances during LTX were uncommon, leading us to suppose that the incidence of PRS could be diminished with retrograde reperfusion.