Preliminary results from the use of intraoperative real‐time biliary oxygen monitoring in liver transplantation

Ciria, Rubén; Navarro, Elena; Sánchez-Frías, Marina; Gallardo, Arsenio; Medina, J. Sáenz; Ayllón, María-Dolores; Gómez‐Luque, Irene; Ruiz-Rabelo, Juan; Luque, Antonio; Mata, Manuel de la; Rufián, Sebastián; López‐Cillero, Pedro; Briceño, Javier

doi:10.1111/ctr.13433

Cited by 2 publications

(1 citation statement)

References 25 publications

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“…Three features of bile duct injury, mural stromal, peribiliary vascular plexus (PVP) and deep peribiliary gland (DPG) injury, were associated with biliary strictures and formed the BDI score. The BDI score has been used to identify grafts at high risk of post-transplant biliary stricture and to compare the efficacy of interventions to preserve the biliary tree [11][12][13][14][15]. However, the score has never been externally validated.…”

Section: Introductionmentioning

confidence: 99%

Histological Assessment of the Bile Duct before Liver Transplantation: Does the Bile Duct Injury Score Predict Biliary Strictures?

Ly,

Lau,

McKenzie

et al. 2023

JCM

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Introduction: Histological injury to the biliary tree during organ preservation leads to biliary strictures after liver transplantation. The Bile Duct Injury (BDI) score was developed to assess histological injury and identify the grafts most likely to develop biliary strictures. The BDI score evaluates the bile duct mural stroma, peribiliary vascular plexus (PVP) and deep peribiliary glands (DPGs), which were correlated with post-transplant biliary strictures. However, the BDI score has not been externally validated. The aim of this study was to verify whether the BDI score could predict biliary strictures at our transplant centre. Methods: Brain-dead donor liver grafts transplanted at a single institution from March 2015 to June 2016 were included in this analysis. Bile duct biopsies were collected immediately before transplantation and assessed for bile duct injury by two blinded pathologists. The primary outcome was the development of clinically significant biliary strictures within 24 months post-transplant. Results: Fifty-seven grafts were included in the study which included 16 biliary strictures (28%). Using the BDI score, mural stromal, PVP and DPG injury did not correlate with biliary strictures including Non-Anastomotic Strictures. Severe inflammation (>50 leucocytes per HPF) was the only histological feature inversely correlated with the primary outcome (absent in the biliary stricture group vs. 41% in the no-stricture group, p = 0.001). Conclusions: The current study highlights limitations of the histological assessment of bile duct injury. Although all grafts had bile duct injury, only inflammation was associated with biliary strictures. The BDI score was unable to predict post-transplant biliary strictures in our patient population.

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Section: Introductionmentioning

confidence: 99%

Histological Assessment of the Bile Duct before Liver Transplantation: Does the Bile Duct Injury Score Predict Biliary Strictures?

Ly,

Lau,

McKenzie

et al. 2023

JCM

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Intraoperative oxygen tension and redox homeostasis in Pseudomyxoma peritonei: A short case series

et al. 2023

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IntroductionPseudomyxoma peritonei (PMP) is a rare malignant disease characterized by a massive multifocal accumulation of mucin within the peritoneal cavity. The current treatment option is based on complete cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy. However, the recurrence is frequent with subsequent progression and death. To date, most of the studies published in PMP are related to histological and genomic analyses. Thus, the need for further studies unveiling the underlying PMP molecular mechanisms is urgent. In this regard, hypoxia and oxidative stress have been extensively related to tumoral pathologies, although their contribution to PMP has not been elucidated.MethodsIn this manuscript, we have evaluated, for the first time, the intratumoral real-time oxygen microtension (pO2mt) in the tumor (soft and hard mucin) and surrounding healthy tissue from five PMP patients during surgery. In addition, we measured hypoxia (Hypoxia Inducible Factor-1a; HIF-1α) and oxidative stress (catalase; CAT) markers in soft and hard mucin from the same five PMP patient samples and in five control samples.ResultsThe results showed low intratumoral oxygen levels, which were associated with increased HIF-1α protein levels, suggesting the presence of a hypoxic environment in these tumors. We also found a significant reduction in CAT activity levels in soft and hard mucin compared with healthy tissue samples.DiscussionIn conclusion, our study provides the first evidence of low intratumoral oxygen levels in PMP patients associated with hypoxia and oxidative stress markers. However, further investigation is required to understand the potential role of oxidative stress in PMP in order to find new therapeutic strategies.

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Preliminary results from the use of intraoperative real‐time biliary oxygen monitoring in liver transplantation

Cited by 2 publications

References 25 publications

Histological Assessment of the Bile Duct before Liver Transplantation: Does the Bile Duct Injury Score Predict Biliary Strictures?

Histological Assessment of the Bile Duct before Liver Transplantation: Does the Bile Duct Injury Score Predict Biliary Strictures?

Intraoperative oxygen tension and redox homeostasis in Pseudomyxoma peritonei: A short case series

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