Early assessment of reperfusion injury by intraoperative quantification of hepatic microcirculation in patients

Klar, E.; Bredt, M.; Kraus, Thomas; Angelescu, M; Mehrabi, Arianeb; Senninger, N.; Otto, Gerd; Herfarth, Christian

doi:10.1016/s0041-1345(96)00120-0

Cited by 25 publications

(11 citation statements)

References 7 publications

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“…The increased expression of adhesion molecules, with subsequent leucocyte and endothelial cell interaction, may also play a crucial role in these changes in the microcirculation, especially during the late phase of reperfusion injury 31 . It has been reported that the changes in microcirculation during the immediate reperfusion period in liver transplantation correspond directly with the maximum postoperative enzyme release from the liver 32 , and are of value in assessing and predicting the degree of liver injury 4 .…”

Section: Discussionmentioning

confidence: 99%

Continuous infusion ofN-acetylcysteine reduces liver warm ischaemia–reperfusion injury

Glantzounis

Yang

Koti

et al. 2004

British Journal of Surgery

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Section: Discussionmentioning

confidence: 99%

Continuous infusion ofN-acetylcysteine reduces liver warm ischaemia–reperfusion injury

Glantzounis

Yang

Koti

et al. 2004

British Journal of Surgery

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“…In the past, available thermodiffusion devices were handicapped by specific limitations, particularly the necessity to induce a temporary "noflow" situation for preliminary measurement of the effective tissue conductivity (11,12). A new prototype device avoiding no-flow calibration proved to be a valid technique for continuous monitoring of renal and hepatic perfusion in a porcine model and has been transferred to the clinical setting for quantification of hepatic microcirculation after liver transplantation (13)(14)(15).…”

mentioning

confidence: 99%

Assessment of renal graft function by perioperative monitoring of cortical microcirculation in kidney transplantation.1

et al. 2003

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Thermodiffusion could be clinically applicable for the perioperative monitoring of renal graft perfusion. Intraoperative reduction of cortical microcirculation has a high predictive value with respect to detection of delayed renal function. Postoperatively, impaired renal microperfusion is associated with acute tubular necrosis. Living-related donor grafts show less microcirculatory alteration than cadaveric kidneys.

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“…The first step has been done by introducing, for the analysis of the microcirculation, laser Doppler flowmetry and thermodiffusion techniques in clinical liver transplantation (65,148). These clinical studies have shown that microvascular graft perfusion negatively correlates with cold ischemia time (148) and reperfusionassociated parenchymal injury (63), and that thermodiffusion indeed allows for early detection of acute rejection episodes (62). While laser Doppler flowmetry and thermodiffusion analysis do not allow direct visualization of organ microcirculation, this can be achieved by a recently introduced technique, termed orthogonal polarization spectral (OPS) imaging (40).…”

Section: Discussionmentioning

confidence: 99%

Role of Microcirculation in Transplantation

Menger

Vollmar

2000

Microcirculation

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Microcirculatory derangements in organ transplantation, characterized by capillary perfusion failure and inflammation-associated leukocyte recruitment, are major determinants for the manifestation of graft dysfunction and destruction. Although preservation/cold storage, posttransplant reperfusion, and rejection have to be considered as individual factors that contribute to injury, recent studies have indicated that ischemia-reperfusion-associated events may trigger immune-response-mediated late rejection. There is major evidence that the microcirculatory derangements induced by cold preservation and reperfusion involve oxygen radicals, complement, phospholipase A2, leukotrienes, thromboxane, platelet-activating factor, and endothelin-1 as well as the activation and function of leukocytic and endothelial selectins, beta 2-integrins, and ICAM-1. This view is based on the fact that blockade or neutralization of these inflammatory mediators and adhesion molecules results in significant amelioration of microvascular graft dysfunction. In parallel, rejection-mediated microcirculatory derangements may not only be ameliorated by immunosuppressive agents, such as cyclosporin, deoxyspergualin, or RS61443, but may, in addition, effectively be inhibited by counteracting oxygen radicals, complement, platelet-activating factor, and adhesion molecules. The introduction of novel techniques for the study of the microcirculation in men, such as thermodiffusion and orthogonal polarization spectral imaging, may in the future assist in improving both early diagnosis of microcirculatory derangements and monitoring of appropriateness of therapy in clinical transplantation surgery.

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Early assessment of reperfusion injury by intraoperative quantification of hepatic microcirculation in patients

Cited by 25 publications

References 7 publications

Continuous infusion ofN-acetylcysteine reduces liver warm ischaemia–reperfusion injury

Continuous infusion ofN-acetylcysteine reduces liver warm ischaemia–reperfusion injury

Assessment of renal graft function by perioperative monitoring of cortical microcirculation in kidney transplantation.1

Role of Microcirculation in Transplantation

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