Hepatic cell membrane damage during cold preservation sensitizes liver grafts to rewarming injury

Nowak, G.; Ungerstedt, Johan; Wernerson, Annika; Ungerstedt, Urban; Ericzon, Bo‐Göran

doi:10.1007/s00534-002-0760-4

Cited by 42 publications

(38 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Organs from NHBD (non-heart-beating donors) seem to be an option to alleviate the problem of liver donor shortage effectively [1] . However, warm ischemia to the liver related to cardiac arrest remained a main obstacle to the use of livers from NHBD [2][3][4] . Moreover, in liver transplantation, the allograft sustains inevitable cold ischemia in addition to rewarming injury during liver reperfusion [5] .…”

Section: Introductionmentioning

confidence: 99%

Safe time to warm ischemia and posttransplant survival of liver graft from non-heart-beating donors

He¹

2004

WJG

View full text Add to dashboard Cite

AIM:To explore the dynamical changes of histology, histochemistry, energy metabolism, liver microcirculation, liver function and posttransplant survival of liver graft in rats under different warm ischemia times (WIT) and predict the maximum limitation of liver graft to warm ischemia. METHODS:According to WIT, the rats were randomized into 7 groups, with WIT of 0, 10, 15, 20, 30, 45, 60 min, respectively. The recovery changes of above-mentioned indices were observed or measured after liver transplantation. The graft survival and postoperative complications in each subgroup were analyzed. RESULTS:Liver graft injury was reversible and gradually resumed normal structure and function after reperfusion when WIT was less than 30 min. In terms of graft survival, there was no significant difference between subgroups within 30 min WIT. When WIT was prolonged to 45 min, the recipients' long-term survival was severely insulted, and both function and histological structure of liver graft developed irreversible damage when WIT was prolonged to 60 min. CONCLUSION:The present study indicates that rat liver graft can be safely subjected to warm ischemia within 30 min. The levels of ATP, energy charge, activities of glycogen, enzyme-histochemistry of liver graft and its recovery potency after reperfusion may serve as the important criteria to evaluate the quality of liver graft.

show abstract

Section: Introductionmentioning

confidence: 99%

Safe time to warm ischemia and posttransplant survival of liver graft from non-heart-beating donors

He¹

2004

WJG

View full text Add to dashboard Cite

show abstract

“…The monitoring may be extended into the post-transplantation period. During cold preservation of pig livers for up to 15 hours, there was a progressive increase of tissue glycerol concentrations (Nowak 2003). Pig livers stored cold for 24 hours after preservation with different solutions demonstrated increasing tissue glycerol concentrations that may correlate to liver enzyme release and other signs of tissue injury (Puhl 2006).…”

Section: Heart Preservationmentioning

confidence: 99%

“…It is not known whether the earlier described pathways for glycerol release during myocardial ischemia also apply to prolonged cold cardioplegic storage. Studies of porcine cold hepatic preservation have demonstrated glycerol accumulation with correlation to duration of storage (Nowak 2003), and demonstrated an association between higher glycerol concentrations and other signs of tissue injury (Puhl 2006). …”

Section: Myocardial Glycerolmentioning

confidence: 99%

Myocardial ischemia-reperfusion and cardioprotection: a study with microdialysis in a porcine model

Metzsch

2011

Acta Anaesthesiologica Scandinavica

View full text Add to dashboard Cite

“…Microdialysis can been used to monitor energy metabolism in severe brain injury [87] and in liver transplantation [88]. Raised lactate-to-pyruvate ratio (L/P ratio) and glycerol levels are reliable markers for ischaemia and cell membrane damage respectively [89].…”

Section: Monitoring Regional Perfusionmentioning

confidence: 99%

Fluid therapy and perfusional considerations during resuscitation in critically ill patients with intra-abdominal hypertension

Regli

Keulenaer²,

Laet³

et al. 2014

Anaesthesiol Intensive Ther

View full text Add to dashboard Cite

Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are consistently associated with morbidity and mortality among the critically ill or injured. Thus, avoiding or potentially treating these conditions may improve patient outcomes. With the aim of improving the outcomes for patients with IAH/ACS, the World Society of the Abdominal Compartment Syndrome recently updated its clinical practice guidelines. In this article, we review the association between a positive fluid balance and outcomes among patients with IAH/ACS and how optimisation of fluid administration and systemic/regional perfusion may potentially lead to improved outcomes among this patient population. Evidence consistently associates secondary IAH with a positive fluid balance. However, despite increased research in the area of non-surgical management of patients with IAH and ACS, evidence supporting this approach is limited. Some evidence exists to support implementing goal-directed resuscitation protocols and restrictive fluid therapy protocols in shocked and recovering critically ill patients with IAH. Data from animal experiments and clinical trials has shown that the early use of vasopressors and inotropic agents is likely to be safe and may help reduce excessive fluid administration, especially in patients with IAH. Studies using furosemide and/or renal replacement therapy to achieve a negative fluid balance in patients with IAH are encouraging. The type of fluid to be administered in patients with IAH remains far from resolved. There is currently insufficient evidence to recommend the use of abdominal perfusion pressure as a resuscitation endpoint in patients with IAH. However, it is important to recognise that IAH either abolishes or increases threshold values for pulse pressure variation and stroke volume variation to predict fluid responsiveness, while the presence of IAH may also result in a false negative passive leg raising test. Correct fluid therapy and perfusional support during resuscitation form the cornerstone of medical management in patients with abdominal hypertension. Controlled studies determining whether the above medical interventions may improve outcomes among those with IAH/ACS are urgently required.

show abstract

Hepatic cell membrane damage during cold preservation sensitizes liver grafts to rewarming injury

Cited by 42 publications

References 40 publications

Safe time to warm ischemia and posttransplant survival of liver graft from non-heart-beating donors

Safe time to warm ischemia and posttransplant survival of liver graft from non-heart-beating donors

Myocardial ischemia-reperfusion and cardioprotection: a study with microdialysis in a porcine model

Fluid therapy and perfusional considerations during resuscitation in critically ill patients with intra-abdominal hypertension

Contact Info

Product

Resources

About