Document Detail


Mechanism of cold ischemia-reperfusion-induced graft injury after orthotopic liver transplantation in rats.
MedLine Citation:
PMID:  11268969     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/AIMS: The purpose of this study was to clarify the mechanism of cold ischemia-reperfusion-induced graft injury after liver transplantation, especially with regard to the relationship between hepatocyte, sinusoidal endothelial cell injury, and hepatic hemodynamic alteration. METHODOLOGY: We evaluated changes in hepatocyte and sinusoidal endothelial cell function, and hepatic hemodynamics after reperfusion in an isogeneic rat liver-transplantation model. The livers of male LEW rats were stored in 4 degrees C lactated Ringer's solution for 1 hr, 3 hr (viable graft), and 6 hr (nonviable graft) before implantation. After reperfusion, hepatocyte function was assessed by serum alanine aminotransferase level and bile output; sinusoidal endothelial cell function was evaluated by serum hyaluronic acid level. Furthermore, we measured hepatic venous oxygen saturation, and portal venous blood flow using a transit time blood flow meter. RESULTS: At 2 hr after reperfusion, the hepatocyte function was similar in all groups. However, the sinusoidal endothelial cell function deteriorated severely in the nonviable graft group, and significantly decreased hepatic venous oxygen saturation levels were observed, suggesting poor hepatic circulation. At 4 hr after reperfusion, the hepatocyte injury was markedly increased in the nonviable graft group. Although systemic blood pressure remained stable, significantly decreased portal venous blood flow in the nonviable graft group was found compared with the viable graft groups. Histopathological studies showed that massive ischemic necrosis was seen in zone III (central) of hepatic lobule 8 hr after reperfusion in the nonviable graft group. CONCLUSIONS: These data suggest that the sinusoidal endothelial cell injury was predominant in the early phase of reperfusion, and might cause microcirculatory disturbances, resulting in decreased portal venous blood flow. This phenomenon may subsequently cause ischemic damage to the hepatocyte, with eventual graft failure.
Authors:
H Shimizu; M Miyazaki; H Ito; K Nakagawa; S Ambiru; A Kato; Y Nukui; S Nozawa; N Nakajima
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hepato-gastroenterology     Volume:  48     ISSN:  0172-6390     ISO Abbreviation:  Hepatogastroenterology     Publication Date:    2001 Jan-Feb
Date Detail:
Created Date:  2001-03-27     Completed Date:  2001-07-26     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8007849     Medline TA:  Hepatogastroenterology     Country:  Greece    
Other Details:
Languages:  eng     Pagination:  216-9     Citation Subset:  IM    
Affiliation:
First Department of Surgery, School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260, Japan.
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MeSH Terms
Descriptor/Qualifier:
Animals
Blood Flow Velocity
Cold Temperature*
Endothelium, Vascular / pathology,  physiopathology*
Graft Survival
Hepatocytes / pathology,  physiology*
Hyaluronic Acid / blood
Liver / blood supply*,  pathology,  physiopathology
Liver Circulation
Liver Function Tests
Liver Transplantation / adverse effects*
Male
Oxygen / blood
Portal Vein
Rats
Rats, Inbred Lew
Reperfusion Injury / blood,  etiology,  pathology,  physiopathology*
Transplantation, Isogeneic
Chemical
Reg. No./Substance:
7782-44-7/Oxygen; 9004-61-9/Hyaluronic Acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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