Hepatic Xanthine Levels as Viability Predictor of Livers Procured From Non-Heart-Beating Donor Pigs1

Net, M.; Valero, Ricard; Almenara, R; Rull, R.; González, Francisco; Taurà, Pilar; López-Boado, M.Á.; Deulofeu, R.; Elena, Montse; Capdevila, Lluís; Cabrer, C; Visa, Josep; García‐Valdecasas, Juan Carlos

doi:10.1097/00007890-200105150-00009

Cited by 39 publications

(34 citation statements)

References 29 publications

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“…It is suggested that graft viability does not depend on the availability of AMP to be rephosphorylated to ATP (30). In agreement with this idea, another protective effect of NR arises from the fact that NR significantly reduces the levels of hepatic xanthine ( Figure 1B) (15,22,31).…”

Section: Discussionmentioning

confidence: 65%

The Effect of Normothermic Recirculation is Mediated by Ischemic Preconditioning in NHBD Liver Transplantation

Net¹,

Valero²,

Almenara³

et al. 2005

American Journal of Transplantation

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111

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We have evaluated the involvement of hepatic preconditioning mediators (adenosine, adenosine A1 and A2 receptors) during normothermic recirculation (NR) in a model of liver transplantation from non-heart-beating donor (NHBD) pigs.Application of NR after 20 min of warm ischemia (WI) reversed the lethal injury associated with transplantation of NHBD livers (achieving 5-day survival and diminishing glutathione S-transferase (GST), aspartate aminotransferase (AST) and hyaluronic acid (HA)).Adenosine administration prior to WI simulated the effect of NR. Measuring adenosine, we found that during NR, hepatic adenosine levels increased and xanthine levels decreased. Then when we blocked A2 receptors the effect of NR was abolished, whereas the blocking of A1 receptors further protected the liver. Furthermore, A2 blocking improved hepatic perfusion during NR whereas A1 blocking reduced it.The study suggests that NR has a preconditioning effect by maintaining adequate adenosine and xanthine levels. During NR, adenosine protects the liver through A2 activation and damages it through A1 activation although simultaneous stimulation of both receptors exerts a clear beneficial effect. The possible relation of NR mechanism with other preconditioning mediators such as cAMP and nitric oxide synthesis are discussed.

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Section: Discussionmentioning

confidence: 65%

The Effect of Normothermic Recirculation is Mediated by Ischemic Preconditioning in NHBD Liver Transplantation

Net¹,

Valero²,

Almenara³

et al. 2005

American Journal of Transplantation

Self Cite

111

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“…The involvement of XOD in stress oxidative and hepatic injury associated with liver transplantation is well known (35,49,50). High levels of either hypoxanthine or xanthine have been considered as markers of low survival rates in liver transplantation (51)(52)(53). The benefits of ischemic preconditioning on xanthine/XOD have been previously reported (35,54).…”

Section: Discussionmentioning

confidence: 95%

Protection of Reduced-Size Liver for Transplantation

Franco-Gou¹,

Peralta²,

Massip-Salcedo

et al. 2004

American Journal of Transplantation

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The shortage of available organs for liver transplantation has motivated the development of new surgical techniques such as reduced-size liver transplantation. Ischemia-reperfusion (I/R) associated with liver transplantation impairs liver regeneration. Ischemic preconditioning is effective against I/R injury in clinical practice of liver tumour resections. The present study evaluated the effect of ischemic preconditioning on reduced-size liver for transplantation and attempted to identify the underlying protective mechanisms. Hepatic injury and regeneration (transaminases, proliferating cell nuclear antigen [PCNA] labeling index, and hepatocyte growth factor [HGF]) were assessed after reduced-size orthotopic liver transplantation (ROLT). Energy metabolism, oxidative stress, tumor necrosis factor-a (TNF) and interleukin-6 (IL-6) were examined as possible mechanisms involved in liver regeneration. Ischemic preconditioning reduced transaminase levels and increased HGF levels and the percentage of PCNApositive hepatocytes after ROLT. This was associated with a decrease in oxidative stress following ROLT, whereas energy metabolism and hepatic IL-6 and TNF release were unchanged. The benefits of ischemic preconditioning on hepatic injury and liver regeneration could be mediated, at least partially by nitric oxide. These results suggest a new potential application of ischemic preconditioning in reduced-size liver transplantation.

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“…66 In addition, other biomarkers, including xanthine, hypoxanthine, hyaluronic acid, and reduced glutathione have been suggested for the assessment of graft viability. [67][68][69][70][71] Therefore, evaluating these biomarkers in DCD liver grafts prior to implant would be helpful. However, some technical limitations (such as the inability to identify these biomarkers in peripheral body fluids), technical demands, and time constraints in the clinical setting preclude these biomarkers from being incorporated into current practice.…”

Section: Figure 2 Ex Vivo Normothermic Machine Perfusion Systemmentioning

confidence: 99%

Untitled

2015

Exp Clin Transplant

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There are increasing numbers of patients on liver transplant waiting lists, and there is a continuing organ shortage crisis. Therefore, more centers and organ procurement organizations are developing protocols for donation after cardiac death. However, the effect of donation after cardiac death allografts on overall patient survival remains controversial, with some centers reporting equivalent patient posttransplant survival but many others indicating increased rates of complications, retransplant, utilization of resources, and death. Several potential risk factors that predict graft loss and recipient complications have been identified. To improve patient outcomes and reduce dropouts, experimental strategies that target both donors and recipients at various phases of the transplant process have focused on attenuating ischemia-reperfusion injury and have achieved encouraging results. In the present article, our goal is to provide an overview of the current status of, and recent advances in, liver transplant from donation after cardiac death, to better understand the risks and potential benefits of donation after cardiac death liver transplant.

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Hepatic Xanthine Levels as Viability Predictor of Livers Procured From Non-Heart-Beating Donor Pigs1

Abstract: It is suggested that xanthine content in the donor is able to predict survival after transplantation. Xanthine is significantly involved in the hepatic lesion elicited by warm ischemia and subsequent ischemia-reperfusion associated to liver transplantation from a NHBD.

Cited by 39 publications

References 29 publications

The Effect of Normothermic Recirculation is Mediated by Ischemic Preconditioning in NHBD Liver Transplantation

The Effect of Normothermic Recirculation is Mediated by Ischemic Preconditioning in NHBD Liver Transplantation

Protection of Reduced-Size Liver for Transplantation

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