The Deleterious Effect of Donor High Plasma Sodium and Extended Preservation in Liver Transplantation

Figueras, Juan; Busquets, Juli; Grande, Luís; Jaurrieta, Eduardo; Perez-Ferreiroa, Julio; Mir, José; Margarit, C; López, Pedro Benito; Vázquez, J; Casanova, Daniel; Bernardos, Á.; De-Vicente, Emilio; Parrilla, Pascual; Ramón, José; Bou, Ricardo

doi:10.1097/00007890-199602150-00016

Cited by 104 publications

(56 citation statements)

References 13 publications

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“…Cold storage of livers for more than 12 to 18 h carried the risk for graft failure [31][32][33][34] and post-transplantation infection [35] . In recent years, preconditioning has been used to prolong hepatic cold ischemia [6,[36][37][38] .…”

Section: Discussionmentioning

confidence: 99%

Protective effect of doxorubicin induced heat shock protein 72 on cold preservation injury of rat livers

Chen

Yu²,

Zhang³

et al. 2004

WJG

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AIM:To observe the protective effect of heat shock protein 72 (HSP 72) induced by pretreatment of doxorubicin (DXR) on long-term cold preservation injury of rat livers. METHODS:Sprague-Dawley rats were administered intravenously DXR at a dose of 1 mg/kg body mass in DXR group and saline in control group. After 48 h, the rat liver was perfused with cold Linger's and University of Wisconsin (UW) solutions and then was preserved in UW solution at 4 for 24, 36 and 48 h. AST, ALT, LDH and hyaluronic acid in preservative solution were determined. Routine HE, immunohistochemical staining for HSP 72 and electron microscopic examination of hepatic tissues were performed. RESULTS:After 24, 36 and 48 h, the levels of AST, ALT and hyaluronic acid in preservative solution were significantly higher in control group than in DXR group (P<0.05), while LDH level was not significantly different between the 2 groups (P>0.05). Hepatic tissues in DXR group were morphologically normal and significantly injured in control group. HSP 72 was expressed in hepatocytes and sinusoidal endothelial cells in DXR group but not in control group.CONCLUSION: Pretreatment of DXR may extend the time of rat liver cold preservation and keep liver alive. The expression of HSP 72 in liver can prevent hepatocytes and sinusoidal endothelial cells from long-term cold preservation injury.

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Section: Discussionmentioning

confidence: 99%

Protective effect of doxorubicin induced heat shock protein 72 on cold preservation injury of rat livers

Chen

Yu²,

Zhang³

et al. 2004

WJG

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“…The introduction of the University of Wisconsin solution more than 10 years ago extended the time of cold storage between harvesting and transplantation. 1,2 Preservation of livers before transplantation for more than 12 to 18 hours still carries the risk for compromising the function of the future graft, [3][4][5][6] and favors posttransplantation infection. 7 One of the most promising strategies that lengthens the time of cold ischemia without risking reperfusion injury is preconditioning.…”

mentioning

confidence: 99%

Extended preservation of rat liver graft by induction of heme oxygenase-1

et al. 2002

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Livers can be preserved only for a short period without jeopardizing the transplantation outcome. Heat shock proteins (HSPs) protect against ischemia and reperfusion injury. We studied whether their induction and, in particular, the induction of heme oxygenase 1 (HO-1), improves transplantation survival after an extended time of cold storage. Rats were subjected to heat preconditioning (42°C for 20 minutes). Livers were harvested 24 hours later, preserved in cold University of Wisconsin solution for 44 hours, and transplanted in isogeneic rats (arterialized transplantation). HO-1 was specifically induced and inhibited by cobalt protoporphyrin and tin protoporphyrin, respectively. All animals receiving a graft without preconditioning and subjected to 44 hours of cold preservation died within 3 days, whereas 89% of rats who received a graft exposed to heat survived for 3 weeks (P ‫؍‬ .0004). Preconditioning reduced serum aspartate transaminase (AST) and lactate dehydrogenase activities after reperfusion, improved bile flow, and decreased the histologic lesions of reperfusion injury. These significant effects of heat preconditioning were prevented by administration of tin protoporphyrin and could be reproduced by administration of cobalt protoporphyrin. In grafts without preconditioning, only a small fraction (<5%) of hepatocytes were positive with the terminal deoxynucleotide transferase-mediated dUTP nick-end labeling (TUNEL) assay, and even less expressed activated caspase 3. Preconditioning tended to reduce the number of positive cells and to stimulate the expression of antiapoptotic Bcl-X L . In conclusion, heat preconditioning and, specifically, overexpression of HO-1 improve posttransplantation survival and graft function after prolonged cold ischemia preservation. The mechanism underlying these beneficial effects does not appear to be prevention of apoptosis. (HEPATOLOGY 2002;35:1082-1092

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“…Both ABO incompatibility and donor plasma sodium > 155 mmol·L -1 have been independently associated with an increased rate of recipient death and retransplantation. 125 In a series of 168 liver transplants, a high donor serum sodium concentration, longer cold ischemia time, large platelet transfusion during surgery and prolonged recipient prothrombin time were independently associated with more severe hepatic dysfunction after transplantation. 126 High donor serum sodium concentrations may promote the accumulation of idiogenic osmoles within liver allograft cells.…”

Section: Hepatic Considerationsmentioning

confidence: 99%

Medical management to optimize donor organ potential: review of the literature

Kutsogiannis

Pagliarello

Doig

et al. 2006

Can J Anesth/J Can Anesth

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Purpose: Over the past two decades, the demand for donor organs continues to outpace the number of organs available for transplantation. Parallel with this has been a change in the demographics of organ donors with an increase in older donors and donors with marginal organs as a proportion of the total organ donor pool. Consequently, efforts have been made to improve the medical care delivered to potential organ donors to improve the conversion rate and graft survival of available organs. The purpose of this literature review is to provide updated recommendations for the contemporary management of organ donors after the neurological determination of death in order to maximize the probability of recipient graft survival. Sources:A comprehensive review of the literature obtained through searches of MEDLINE/PubMed, and personal reference files.Principal findings: Contemporary management of the organ donor after neurological determination of death includes therapies to prevent the detrimental effects of the autonomic storm, the use of invasive hemodynamic monitoring and aggressive respiratory therapy including therapeutic bronchoscopy in marginal heart and lung donors, and the use of hormonal therapy including vasopressin, corticosteroids, triiodothyronine or thyroxine, and insulin for the pituitary failure and inflammation seen in brain dead organ donors. The importance of normalizing donor physiology to optimize all available organs is stressed. Conclusion:Aggressive hemodynamic and respiratory management of solid organ donors, coupled with the use of hormonal therapy improves the rate of conversion and graft survival in solid organ recipients. Objectif

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The Deleterious Effect of Donor High Plasma Sodium and Extended Preservation in Liver Transplantation

Cited by 104 publications

References 13 publications

Protective effect of doxorubicin induced heat shock protein 72 on cold preservation injury of rat livers

Protective effect of doxorubicin induced heat shock protein 72 on cold preservation injury of rat livers

Extended preservation of rat liver graft by induction of heme oxygenase-1

Medical management to optimize donor organ potential: review of the literature

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