Energy Charge as an Indication of Liver Viability a Comparison of Changes in Livers That Remained Intact With Those Subjected to Autografting

Hickman, Rosemary; Rose-Innes, C.; Tyler, Marilyn; Bracher, Mona; Lotz, Zoë; Fourie, Jaco

doi:10.1097/00007890-199203000-00009

Cited by 33 publications

(10 citation statements)

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“…4,5 Several experimental and clinical studies have shown beneficial effects in liver grafts perfused with arterial blood first. [6][7][8] However, quantitative evidence of the advantage of early rearterialization has been limited.…”

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confidence: 99%

Effect of early arterialization of the porcine liver allograft on reperfusion injury, hepatocellular injury, and endothelial cell dysfunction

Lotz

Tyler

et al. 2001

Liver Transplantation

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The conventional technique of liver transplantation involves the initial perfusion of the graft with portal blood. However, recent evidence suggests that initial arterialization of the graft may be better. The aim of this study is to evaluate the timing of arterialization on reperfusion injury, hepatocellular injury, and endothelial cell function after liver transplantation. Large white X Landrace pigs (n ‫؍‬ 24) were subjected to orthotopic liver transplantation. The animals were randomly assigned to 4 groups, ranging from late arterialization (60 minutes after portal reperfusion) to early rearterialization (20 minutes before portal reperfusion). Aspartate aminotransferase levels continued to increase 4 hours posttransplantation in group 1 (late arterialization), but remained stable after 1 hour posttransplantation in group 4 (early rearterialization). Levels of malondialdehyde doubled in all groups after portal reperfusion with the exception of group 4, in which the liver received arterial blood before portal reperfusion. Vitamin A levels decreased in all groups after revascularization, but the decrease was more pronounced and prolonged in groups 1 and 2 (late arterialization) compared with groups 3 and 4 (early rearterialization). Hyaluronic acid levels continued to increase in all groups until 1 hour posttransplantation except in group 4, in which the level decreased from 20 minutes posttransplantation. Results of this study show that early rearterialization is associated with less hepatocellular damage, less reperfusion injury, and improved liver endothelial cell function. In conclusion, our results indicate that early rearterialization of the graft is beneficial to the transplanted liver. (Liver Transpl 2001;7:32-37.)

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confidence: 99%

Effect of early arterialization of the porcine liver allograft on reperfusion injury, hepatocellular injury, and endothelial cell dysfunction

Lotz

Tyler

et al. 2001

Liver Transplantation

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“…In the sham group, only the hepatic pedicle was identified. In the IR alone and IR ϩ amrinone groups, hepatic ischemia was induced for 60 min [2,20] by cross-clamping the hepatic artery, portal vein, and bile duct (Pringle maneuver) with a vascular microclip. Rats were subjected to hepatic ischemia for 60 min, but portal congestion was prevented by the extracorporeal shunt.…”

Section: Methodsmentioning

confidence: 99%

Effects of Amrinone in an Experimental Model of Hepatic Ischemia-Reperfusion Injury

Küçük

Akçan

Akyýldýz

et al. 2009

Journal of Surgical Research

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“…In our own unit, we consider blood pressure < 50 mmHg and oxygen saturation < 80% as heralding the beginning of warm ischemia. Intracellular energy charge is paramount for cellular viability [23,24] . In the absence of oxygenated perfusion during warm ischemia, anaerobic metabolism heralds intracellular energy depletion, lactic acidosis and paralysis of energy driven Na + /K + pumps that maintain cell membrane integrity culminating in edema, intracellular vacuolation and cell death.…”

Section: Pathophysiology Of Dcdmentioning

confidence: 99%

Current status and recent advances of liver transplantation from donation after cardiac death

Perera

Bramhall

2011

WJGS

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The last decade saw increased organ donation activity from donors after cardiac death (DCD). This contributed to a significant proportion of transplant activity. Despite certain drawbacks, liver transplantation from DCD donors continues to supplement the donor pool on the backdrop of a severe organ shortage. Understanding the pathophysiology has provided the basis for modulation of DCD organs that has been proven to be effective outside liver transplantation but remains experimental in liver transplantation models. Research continues on how best to further increase the utility of DCD grafts. Most of the work has been carried out exploring the use of organ preservation using machine assisted perfusion. Both ex-situ and in-situ organ perfusion systems are tested in the liver transplantation setting with promising results. Additional techniques involved pharmacological manipulation of the donor, graft and the recipient. Ethical barriers and end-of-life care pathways are obstacles to widespread clinical application of some of the recent advances to practice. It is likely that some of the DCD offers are in fact probably "prematurely" offered without ideal donor management or even prior to brain death being established. The absolute benefits of DCD exist only if this form of donation supplements the existing deceased donor pool; hence, it is worthwhile revisiting organ donation process enabling us to identify counter remedial measures.

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Energy Charge as an Indication of Liver Viability a Comparison of Changes in Livers That Remained Intact With Those Subjected to Autografting

Cited by 33 publications

References 0 publications

Effect of early arterialization of the porcine liver allograft on reperfusion injury, hepatocellular injury, and endothelial cell dysfunction

Effect of early arterialization of the porcine liver allograft on reperfusion injury, hepatocellular injury, and endothelial cell dysfunction

Effects of Amrinone in an Experimental Model of Hepatic Ischemia-Reperfusion Injury

Current status and recent advances of liver transplantation from donation after cardiac death

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