Document Detail

A study of the metabolites of ischemia-reperfusion injury and selected amino acids in the liver using microdialysis during transplantation.
MedLine Citation:
PMID:  15818326     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Preservation and ischemia-reperfusion injury still impact the outcome of orthotopic liver transplantation. The authors used microdialysis with a view to monitoring its effect on graft function. METHODS: A microdialysis catheter was inserted into the graft immediately after reperfusion and perfused with an isotonic solution for 48 hr. Metabolites of the ischemia-reperfusion injury and selected amino acids were studied. There were 18 patients, with a median age of 52 years (range, 38-62 years), 8 of whom were men. Lactate, pyruvate, glycerol, and glucose levels were measured. In addition, alanine, arginine, citrulline, gamma-aminobutyric acid (GABA), glutamate, glutamine, glycine, and taurine were determined. RESULTS: All grafts functioned well. High lactate, pyruvate, and glycerol levels were observed in the immediate postoperative period. These showed a significant rapid decrease and stabilized to baseline levels. Alanine, glutamate, GABA, and taurine levels declined significantly to baseline values. Arginine levels were low immediately postreperfusion and then increased, reaching significantly higher values beyond 19 hr. CONCLUSIONS: These data may represent "normal" changes seen in the immediate posttransplant period because all grafts functioned well. Two important metabolic fates of arginine in the liver are in the detoxification of ammonia by means of the urea cycle, and in the synthesis of nitric oxide (NO). Low extracellular arginine may reflect influx of the amino acid into hepatocytes, resulting in formation of NO in the presence of inducible NO synthase or conversion to ornithine in the presence of arginase in the urea cycle. As the organ stabilizes, restriction of arginine uptake may give rise to the observed increase in extracellular arginine.
Michael A Silva; Douglas A Richards; Simon R Bramhall; David H Adams; Darius F Mirza; Nick Murphy
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Transplantation     Volume:  79     ISSN:  0041-1337     ISO Abbreviation:  Transplantation     Publication Date:  2005 Apr 
Date Detail:
Created Date:  2005-04-08     Completed Date:  2005-05-13     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0132144     Medline TA:  Transplantation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  828-35     Citation Subset:  IM    
Liver Unit, University Hospital Birmingham NHS Trust, Queen Elizabeth, Edgbaston, Birmingham B15 2TH, UK.
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MeSH Terms
Amino Acids / metabolism*
Citrulline / metabolism
Glutamine / metabolism
Glycine / metabolism
Liver / chemistry,  metabolism*,  physiology
Liver Function Tests
Liver Transplantation*
Middle Aged
Reperfusion Injury / metabolism*
Reg. No./Substance:
0/Amino Acids; 372-75-8/Citrulline; 56-40-6/Glycine; 56-85-9/Glutamine

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

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