Intramucosal pH and liver endotoxin clearance during experimental liver transplantation

Golling, M.; Bud, Octavian; Frankenberg, Moritz von; Ulrich, Frank; Schäffer, F; Weiss, G.; Mehrabi, Arianeb; Kraus, Thomas; Urbaschek, Renate; Gebhard, Martha Maria; Herfarth, Christian; Klar, E.

doi:10.1007/s001470050411

Cited by 1 publication

(3 citation statements)

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“…During the “zero flow situation” of ATx, the pHi and LPS cannot be measured in donors. The pHi cutoff indicating survival proposed in our brain‐dead model (pH 7.28) was not confirmed 47. As in previous experiments, during extended use of the passive porto‐jugular VVB, a flow decrease of 20%‐30% was found in the recipient 47.…”

Section: Discussionmentioning

confidence: 47%

“…The pHi cutoff indicating survival proposed in our brain‐dead model (pH 7.28) was not confirmed 47. As in previous experiments, during extended use of the passive porto‐jugular VVB, a flow decrease of 20%‐30% was found in the recipient 47. This could have contributed substantially to the decrease in pHi and increase in LPS, and eventually to the decrease in survival in the NHBD‐90 group.…”

Section: Discussionmentioning

confidence: 51%

“…Changes in pHi, LPS, and ENC are considered valuable local and systemic markers of bowel ischemia, especially in the experimental setting 36–48. Although portal flow is substantially decreased during clamping and VVB, comparable flow during cardiodepression and brain death have shown that macrocirculatory changes in the portal circulation do not necessarily correlate with MP in the bowel mucosa and LPS levels 49, 50.…”

Section: Discussionmentioning

confidence: 99%

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Reduced glutathione in the liver as a potential viability marker in non-heart-beating donors

Golling¹,

Kellner

Fonouni³

et al. 2008

Liver Transpl

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Although the use of non-heart-beating donors (NHBD) is the oldest type of organ transplantation, the results were and still are disappointing. To consider using a liver from NHBD, it is of importance to assess the graft viability. Our aim was to assess the role of reduced liver glutathione (rGSHL) as a potential predictive marker of liver function before transplantation. Autotransplanted livers were subjected to 0, 60, and 90 minutes of ischemia in 20 pigs. We analyzed systemic cardiocirculatory parameters, bowel ischemia by endotoxin, endotoxin-neutralizing capacity, oxidative stress, hepatic perfusion parameters, liver enzymes, local bowel ischemia, and liver oxidative stress (rGSHL and oxidized glutathione in the liver). Autotransplantation was comparable to donor explantation/recipient transplantation with respect to systemic and hepatic parameters. Liver ischemia for 0, 60, and 90 minutes resulted in survival in 100% (NHBD-0), 71% (NHBD-60), and 57% (NHBD-90) of animals. Of all parameters, only hepatic microperfusion, pHi of the sigmoid colon, and bowel ischemia by endotoxin in the NHBD-90 group showed significant changes compared to NHBD-60 and control animals. Although systemic endotoxin-neutralizing capacity and total glutathione in erythrocytes levels were mainly influenced by cold perfusion, hepatic oxidative stress increased with ischemia time. The cut-off value of 11.5 ng/mmol of rGSHL could distinguish survivors from nonsurvivors, independent of the ischemia time. In conclusion, rGSHL has the potential of becoming an important viability marker, as it could predict survival in autotransplantation NHBD model regardless of the ischemia time. Further investigation to declare reasons for differing rGSHL levels within the liver is required. Liver Transpl 14: [1637][1638][1639][1640][1641][1642][1643][1644][1645][1646][1647] 2008. © 2008 AASLD. Received March 13, 2008; accepted June 5, 2008.The use of non-heart-beating donors (NHBD) is the oldest type of solid organ transplantation. With respect to the liver, an important organ, results have been disappointing. Primary liver nonfunction (PNF) is dependent on the donor being in a stable/controlled or unstable/uncontrolled stage. Transplantation from uncontrolled NHBD results in 50%-75% of livers having PNF and a 6-month graft survival of between 17% and 50%.1,2 In adult controlled NHBD, 1-year and 3-year liver graft survival improved up to 69% and 59%, respectively, 3,4 whereas pediatric graft survival from controlled NHBD can now reach 1-year and 5-year graft survival rates of 89% and 79%, respectively.5 Despite this progress, wider application of such livers is under Abbreviations: AF, aortic flow; ALT, alanine aminotransferase; AST, aspartate aminotransferase; ATx, autotransplantation; CVP, central venous pressure; ENC, endotoxin-neutralizing capacity; GSH, glutathione; GSSG, oxidized glutathione; GSSG E , oxidized glutathione in erythrocytes; GSSG L , oxidized glutathione in the liver; HAF, hepatic artery flow; i.v., intravenously; IVC, inferior vena ca...

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Section: Discussionmentioning

confidence: 47%

Section: Discussionmentioning

confidence: 51%