31 results on '"Liver preservation"'
Search Results
2. Cold flush after dynamic liver preservation protects against ischemic changes upon reperfusion – an experimental study.
- Author
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Horn, Charlotte, Paul, Andreas, Minor, Thomas, Hannaert, Patrick, Hauet, Thierry, and Leuvenink, Henri
- Abstract
Summary: Ex vivo machine perfusion of the liver after cold storage has found to be most effective if combined with controlled oxygenated rewarming up to (sub)‐normothermia. On disconnection of the warm graft from the machine, most surgeons usually perform a cold flush of the organ as protection against the second warm ischemia incurred upon implantation. Experimental evidence, however, is lacking and protective effect of deep hypothermia has been challenged for limited periods of liver ischemia in other models. A first systematic test was carried out on porcine livers, excised 30 min after cardiac arrest, subjected to 18 h of cold storage in UW and then machine perfused for 90 min with Aqix‐RSI solution. During machine perfusion, livers were gradually rewarmed up to 20 °C. One group (n = 6) was then reflushed with 4 °C cold Belzer UW solution whereas the second group (n = 6) remained without cold flush. All livers were exposed to 45 min warm ischemia at room temperature to simulate the surgical implantation period. Organ function was evaluated in an established reperfusion model using diluted autologous blood. Cold reflush after disconnection from the machine resulted in a significant increase in bile production upon blood reperfusion, along with a significant reduction in transaminases release alanine aminotransferase and of the intramitochondrial enzyme glutamate dehydrogenase. Interestingly, free radical‐mediated lipid peroxidation was also found significantly lower after cold reflush. No differences between the groups could be evidenced concerning histological injury and recovery of hepatic energy metabolism (tissue content of adenosine triphosphate). Post‐machine preservation cold reflush seems to be beneficial in this particular setting, even if the organs are warmed up only to 20 °C, without notion of adverse effects, and should therefore be implemented in the protocol. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
3. 24-h storage of pig livers in UW, HTK, hydroxyethyl starch, and saline solution: is microdialysis an appropriate method for the continuous graft monitoring during preservation?
- Author
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Puhl, Gero, Olschewski, Peter, Schöning, Wenzel, Neumann, Ulf, Sredznizki, Daniel, Dankof, Anja, Settmacher, Utz, and Neuhaus, Peter
- Subjects
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ISCHEMIA , *LIVER cells , *GLYCERIN , *MICRODIALYSIS , *GLUCOSE , *ENZYMES - Abstract
Recent studies demonstrate the feasibility of microdialysis to monitor metabolism in ischemic livers. Whether these parameters correlate with markers of liver cell integrity in an experimental model using pig livers and different preservation solutions was an aim of this study. Pig livers were flushed with either 4 °C Histidine-Typtophan-Ketoglutarate solution (HTK) (Custodiol®), University of Wisconsin solution (ViaSpan®) , and hydroxyethyl starch, or 12 °C saline solution. After 24-h storage, the livers were rinsed with saline to measure liver enzymes and lactate from the effluate. Utilizing microdialysis, intraparenchymal lactate, pyruvate, glucose, and glycerol was monitored. Tissue biopsies were taken for histological examinations. Cold preservation resulted in a decrease of metabolic activity measured by intrahepatic glucose, lactate, and pyruvate levels, as well as lactate in the effluate, independently of the solution used. Of particular interest, glycerol levels partially reflected the extent of hepatocellular damage and liver enzyme release. Glycerol levels partially discriminated preservation of different quality and were in accordance to histological findings and liver enzyme release. Lactate, pyruvate, and glucose levels were not appropriate as markers during cold storage. Whether or not glycerol monitoring could represent an additional and rational complementation to the current practice of macroscopic, microscopic and donor evaluation has to be clarified by further studies. [ABSTRACT FROM AUTHOR]
- Published
- 2006
- Full Text
- View/download PDF
4. Normothermic liver preservation
- Author
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Henri G. D. Leuvenink, R. Ravikumar, and Peter J. Friend
- Subjects
Risk ,medicine.medical_specialty ,Tissue and Organ Procurement ,medicine.medical_treatment ,Organ Preservation Solutions ,Cold storage ,Liver transplantation ,PERFUSED PORCINE LIVER ,HEART-BEATING DONORS ,COLD-STORAGE ,EXTRACORPOREAL PERFUSION ,Humans ,Medicine ,ISCHEMIC-INJURY ,Intensive care medicine ,Donor pool ,Liver preservation ,normothermic liver perfusion ,Transplantation ,Machine perfusion ,KIDNEY-PRESERVATION ,business.industry ,Graft Survival ,machine perfusion ,HYPOTHERMIC MACHINE PRESERVATION ,Temperature ,Equipment Design ,Liver Transplantation ,Surgery ,Cold Temperature ,Fatty Liver ,Perfusion ,GRAFT FUNCTION ,EX-VIVO ,Marginal donor ,Normothermic perfusion ,Liver ,ORGAN CARE SYSTEM ,organ preservation ,business - Abstract
Despite increasing donor numbers, waiting lists and pre-transplant mortality continue to grow in many countries. The number of donor organs suitable for liver transplantation is restricted by cold preservation and ischemia-reperfusion injury (IRI). Transplantation of marginal donor organs has led to renewed interest in new techniques which have the potential to improve the quality of preservation, assess the quality of the organ and allow repair of the donor organ prior to transplantation. If successful, such techniques would not only improve the outcome of currently transplanted marginal livers, but also increase the donor pool. Experimental evidence suggests that preservation under near physiological conditions of temperature and oxygenation abrogates IRI. Normothermic perfusion maintains the organ in a physiological state, avoiding the depletion of cellular energy and the accumulation of waste products, which occurs with static cold storage. It enables viability assessment prior to transplantation thereby reducing the risk of transplanting inherently marginal organs. Here we review the use of normothermic machine perfusion as a means of organ preservation.
- Published
- 2015
5. Small bowel preservation for intestinal transplantation: a review
- Author
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Anne Margot C. Roskott, Henri G. D. Leuvenink, Lyan G. Koudstaal, Gerard Dijkstra, Vincent B. Nieuwenhuijs, and Rutger J. Ploeg
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Transplantation ,medicine.medical_specialty ,Kidney ,business.industry ,Ischemia ,Cold storage ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Parenteral nutrition ,medicine ,Viaspan ,business ,Perfusion ,Liver preservation - Abstract
Intestinal transplantation has become the therapy of choice for patients with intestinal failure and life-threatening complications from total parenteral nutrition. Results, however, remain inferior as compared with other transplant types with the quality of the organ graft as the most important factor of outcome after transplantation. The intestine is extremely sensitive to ischemia. Unfortunately, a relatively long ischemic preservation period is inevitable. The current standard in organ preservation [cold storage (CS) with University of Wisconsin solution] was developed for kidney/liver preservation and is suboptimal for the intestinal graft despite good results for other organs. This review aimed at appraising the results from the use of previously applied and recently developed preservation solutions and techniques to identify key areas for improvement. As the studies available do not reveal the most effective method for intestinal preservation, an optimal strategy will result from a synergistic effect of different vital elements identified from a review of published material from the literature. A key factor is the composition of the solution using a low-viscosity solution to facilitate washout of blood, including amino acids to improve viability, impermeants and colloids to prevent edema, and buffer for pH-homeostasis. Optimizing conditions include a vascular flush before CS and luminal preservation. The most effective composition of the luminal solution and a practical, clinically applicable optimal technique are yet to reach finality. Short-duration oxygenated arterial and/or luminal perfusion have to be considered. Thus, a tailor-made approach to luminal preservation solution and technique need further investigation in transplant models and the human setting to develop the ultimate technique meeting the physiologic demands of the intestinal graft during preservation.
- Published
- 2010
6. 24-h storage of pig livers in UW, HTK, hydroxyethyl starch, and saline solution: is microdialysis an appropriate method for the continuous graft monitoring during preservation?
- Author
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Utz Settmacher, Peter Olschewski, Ulf Neumann, Gero Puhl, Wenzel Schöning, Peter Neuhaus, Daniel Sredznizki, and Anja Dankof
- Subjects
Glycerol ,Male ,Microdialysis ,Adenosine ,Allopurinol ,Organ Preservation Solutions ,Sus scrofa ,Cold storage ,In Vitro Techniques ,Sodium Chloride ,Hydroxyethyl starch ,Potassium Chloride ,Hydroxyethyl Starch Derivatives ,Raffinose ,Pyruvic Acid ,Animals ,Insulin ,Medicine ,Mannitol ,Viaspan ,Aspartate Aminotransferases ,Lactic Acid ,Liver preservation ,Monitoring, Physiologic ,Transplantation ,L-Lactate Dehydrogenase ,business.industry ,Liver cell ,Organ Preservation ,Metabolism ,Glutathione ,Cold Temperature ,Glucose ,Liver ,Biochemistry ,business ,Procaine ,medicine.drug - Abstract
Summary Recent studies demonstrate the feasibility of microdialysis to monitor metabolism in ischemic livers. Whether these parameters correlate with markers of liver cell integrity in an experimental model using pig livers and different preservation solutions was an aim of this study. Pig livers were flushed with either 4 °C Histidine-Typtophan-Ketoglutarate solution (HTK) (Custodiol®), University of Wisconsin solution (ViaSpan®), and hydroxyethyl starch, or 12 °C saline solution. After 24-h storage, the livers were rinsed with saline to measure liver enzymes and lactate from the effluate. Utilizing microdialysis, intraparenchymal lactate, pyruvate, glucose, and glycerol was monitored. Tissue biopsies were taken for histological examinations. Cold preservation resulted in a decrease of metabolic activity measured by intrahepatic glucose, lactate, and pyruvate levels, as well as lactate in the effluate, independently of the solution used. Of particular interest, glycerol levels partially reflected the extent of hepatocellular damage and liver enzyme release. Glycerol levels partially discriminated preservation of different quality and were in accordance to histological findings and liver enzyme release. Lactate, pyruvate, and glucose levels were not appropriate as markers during cold storage. Whether or not glycerol monitoring could represent an additional and rational complementation to the current practice of macroscopic, microscopic and donor evaluation has to be clarified by further studies.
- Published
- 2006
7. Histidine-tryptophan-ketoglutarate solution for organ preservation in human liver transplantation-a prospective multi-centre observation study
- Author
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Andreas Rosenstingl, Rudolf Steininger, Burckhardt Ringe, Ferdinand Mühlbacher, R. Lange, Herwig Pokorny, Alfred Königsrainer, Susanne Rasoul-Rockenschaub, Thomas Windhager, and Felix B. Langer
- Subjects
Nephrology ,Liver Cirrhosis ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Organ Preservation Solutions ,Liver transplantation ,Potassium Chloride ,Histidine-tryptophan-ketoglutarate ,Internal medicine ,medicine ,Humans ,Mannitol ,Liver preservation ,Survival analysis ,Retrospective Studies ,Transplantation ,business.industry ,Liver Diseases ,Graft Survival ,Liver Neoplasms ,Retrospective cohort study ,Middle Aged ,Survival Analysis ,Surgery ,Liver Transplantation ,Clinical trial ,Europe ,Glucose ,Drug Therapy, Combination ,Female ,business ,Immunosuppressive Agents ,Procaine - Abstract
Based on experimental work and clinical small studies, histidine-tryptophan-ketoglutarate (HTK) solution was found to be suitable not only for heart and kidney preservation but also for liver preservation. We decided, therefore, to use this preservation solution for clinical liver preservation in a prospective multi-centre trial. Enrolment to the study was from 1996 to 1999 in four European centres, and the results of 214 patients with HTK-preserved organs were analysed. Analysis showed a primary dysfunction (PDF) rate of 8.8%, with a primary non-function (PNF) rate of 2.3% and initial poor function (IPF) in 6.5%. Patient survival rate at 1 year was 83% and 1-year graft survival rate was 80%. In a univariate and a multivariate analysis PDF, early surgical complications and tendentiously severe infections (septicaemia, pneumonia, cholangitis) were identified as independent risk factors for graft and patient survival. Preservation with HTK can be regarded as an established alternative to preservation with University of Wisconsin (UW) solution when preservation times are short. Definitive assessment of the efficacy of preservation solutions requires further prospective randomised clinical trials that compare HTK and UW.
- Published
- 2004
8. Anionic polysaccharides
- Author
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Martin K. Schilling, Chifumi Fukuda, Yinghua Tian, T. Schäfer, and Otto Kollmar
- Subjects
chemistry.chemical_classification ,Transplantation ,business.industry ,Pentosan polysulfate ,Polysaccharide ,Lactobionic acid ,chemistry.chemical_compound ,Sulfation ,chemistry ,Biochemistry ,Edema ,medicine ,Liver function ,medicine.symptom ,business ,Liver preservation ,medicine.drug ,Nuclear chemistry - Abstract
In liver preservation, the substitution of the anion Cl(-) by lactobionic acid (LB) prevents reperfusion edema and extends the preservation time for human livers. We studied the effect of compounds that are structurally related to lactobionic acid: anionic polycarbohydrates (sulfated anionic polysaccharide, SAP, and pentosan polysulfate, PPS) on liver function and leukocyte-endothelial cell interaction in isolated perfusion and liver transplant models. Rat livers, cold-stored (24 h) in a Cl(-) -containing control solution, became edematous during 1 h of reperfusion. Substitution of Cl(-) by either LB, SAP, or PPS decreased reperfusion edema in a Cl(-) concentration-dependent fashion. Reperfusion edema was abolished completely after preservation in 100 mM SAP solution or PPS solution. Also hepatic lactic dehydrogenase (LDH) and aspartate aminotransferase (ASAT) release was lowest after preservation in those solutions. After preservation in LB or anionic polycarbohydrate solutions, portal venous resistance was significantly higher than after preservation in Cl(-)-containing control solution. Capillary blood flow was 391 +/- 83 pl/s and 398 +/- 174 pl/s after preservation in SAP solution (SAPs) and PPSs, and 803 +/- 117 pl/s and 641 +/- 219 pl/s after preservation in LB or Cl(-)-containing control solution. The number of leukocytes sticking to the vascular wall was lower ( P < 0.05) after preservation in SAPs or PPSs (109 +/- 31 cells/mm(2) and 108 +/- 60 cells/mm(2), respectively), when compared with preservation in Cl(-)-containing control or LB solutions (429 +/- 63 cells/mm(2) and 277 +/- 59 cells/mm(2)). In rat liver preservation, anionic polysaccharides are antiedematous compounds, with a higher potency than LB and additional antiadhesive properties.
- Published
- 2002
9. Local liberation of cytokines during liver preservation
- Author
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Roland Nohr, J. C. Gerlach, Gabriele Spatkowski, Peter Neuhaus, Katrin Zeilinger, and Achim Jörres
- Subjects
Adult ,Male ,Pathology ,medicine.medical_specialty ,Adenosine ,medicine.drug_class ,medicine.medical_treatment ,Allopurinol ,Sialoglycoproteins ,Organ Preservation Solutions ,Liver transplantation ,Andrology ,Raffinose ,Ischemia ,medicine ,Humans ,Insulin ,Liver preservation ,Transplantation ,business.industry ,Interleukin-6 ,Tumor Necrosis Factor-alpha ,Organ Preservation ,Middle Aged ,Receptor antagonist ,Glutathione ,Tissue Donors ,Liver Transplantation ,Interleukin 1 Receptor Antagonist Protein ,Cytokine ,Liver ,Liberation ,Cytokines ,Tumor necrosis factor alpha ,Female ,Cell activation ,business ,Interleukin-1 - Abstract
In order to investigate locally produced mediators during the process of organ storage in liver transplantation, we collected the liver preservation solution effluent of 15 transplanted livers and compared it with serum samples taken preoperatively from donor and recipient, as well as 60 min after reperfusion. The mean ischemia time +/- SEM was 10 h 10 min +/- 53 min. Mean concentrations in University of Wisconsin preservation solution effluent were: interleukin-(IL-)1beta 154 +/- 77 pg/ml; IL-1 receptor antagonist (IL-1 ra) 1281 +/- 309 pg/ml; IL-6 412 +/- 90 pg/ml; and for tumor necrosis factor-(TNF-)alpha 74 +/- 21 pg/ml. Cytokine levels in the donors were lower than those detected in the effluent. All measured cytokines showed higher concentrations in the effluent compared to those of the recipient prior to the operation. With respect to a comparison of donor and recipient values, no correlation is evident. Likewise, the ischemic time does not correlate with effluent values. Further development of liver preservation concepts requires information about the state of the graft before reperfusion. Data on cytokine liberation may serve as a helpful tool for the further development of preservation concepts because they enable an estimation of cell activation during preservation.
- Published
- 1999
10. Warm flush at 37 degrees C following cold storage attenuates reperfusion injury in preserved rat livers
- Author
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Marcel E. Reinders, Thomas M. van Gulik, Huub C. Gelderblom, Ronald J.A. Wanders, Huug Obertop, Bart A. van Wagensveld, Wilma M. Frederiks, and Other departments
- Subjects
Adenosine ,Hot Temperature ,Allopurinol ,Organ Preservation Solutions ,Cold storage ,Cold Ischemia Time ,Andrology ,chemistry.chemical_compound ,Raffinose ,Nucleotidase ,medicine ,Animals ,Bile ,Insulin ,Viaspan ,Aspartate Aminotransferases ,Hyaluronic Acid ,Rats, Wistar ,Liver preservation ,Transplantation ,L-Lactate Dehydrogenase ,business.industry ,Glutathione ,medicine.disease ,Rats ,Cold Temperature ,Biochemistry ,chemistry ,Liver ,Purine-Nucleoside Phosphorylase ,Reperfusion Injury ,Female ,Tissue Preservation ,business ,Reperfusion injury - Abstract
Pretransplant rinse solutions have been shown to reduce reperfusion injury in cold-stored liver grafts, especially at the nonparenchymal level in sinusoidal endothelial cells (SEC). In this study, different rinse temperatures were tested in a rat liver preservation model. Livers were washed out in situ via the portal vein with cold (4 degrees C) University of Wisconsin (UW) solution, and after hepatectomy (t0), were stored for 8, 16, or 24 h of cold ischemia time (CIT). After storage, livers were flushed with UW solution at either 4 degrees C, 20 degrees C, or 37 degrees C and reperfused for 90 min (37 degrees C). Control livers were reperfused at t0 without preflush. Levels of hyaluronic acid (HA), purine nucleoside phosphorylase (PNP), AST, and LDH were measured in the reperfusion medium. Bile production was monitored during reperfusion. At the end of reperfusion, liver biopsies were taken for enzyme hystochemistry (5'-nucleotidase and LDH). After 8-h CIT and a flush at 4 degrees C, a release of endogenous HA (-7%) was observed, whereas uptake of exogenous HA occurred after the 20 degrees C flush (2%, P = NS) and after the 37 degrees C flush (24%, p < 0.001). HA release occurred at all three preflush temperatures after the 16-h CIT but was significantly lower when flushed at 37 degrees C (-10%) that at 4 degrees C and 20 degrees C (-64% and -17%, respectively, p = 0.05). After the 24-h CIT, the release of endogenous HA increased in the 4 degrees C and 20 degrees C preflush groups, but not in the 37 degrees C group. Levels of PNP and AST increased until the 24-h CIT in all groups but were significantly lower after preflush at 37 degrees C. Release of LDH did not increase with increasing periods of cold storage in any of the flush series. Compared to control livers, mean bile production during reperfusion was significantly decreased following preflush at 4 degrees C or 37 degrees C after all periods of CIT. No differences in mean bile production could be demonstrated in the three preflush groups after any period of CIT. LDH activity in liver tissue was best preserved after the 8 and 16-h CIT in combination with the 37 degrees C preflush, indicating less hepatocellular damage. In conclusion, in cold stored rat livers flushed at 37 degrees C before reperfusion, SEC and hepatocellular damage is attenuated
- Published
- 1998
11. Systemic liberation of interleukin-8 in the perioperative phase of liver transplantation
- Author
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Jörg C. Gerlach, Axel Berger, Roland Nohr, Michael R. Schön, Achim Jörres, Peter Neuhaus, Mark A. Smith, and Gabriele Spatkowski
- Subjects
Nephrology ,Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Graft vs Host Disease ,Liver transplantation ,Cold Ischemia Time ,Tacrolimus ,Internal medicine ,medicine ,Humans ,Interleukin 8 ,Postoperative Period ,Liver preservation ,Transplantation ,business.industry ,Interleukin-8 ,Perioperative ,Middle Aged ,Surgery ,Liver Transplantation ,Cytokine ,Liver ,Anesthesia ,Cyclosporine ,Female ,business ,Immunosuppressive Agents - Abstract
Serum levels of interleukin-8 (IL-8) were investigated in the perioperative phase of liver transplantation (LTx) in order to help determine whether this cytokine might serve as a parameter for preservation injury. In a study of 45 patients undergoing LTx, systemic IL-8 was estimated at the end of the anhepatic phase, at 30, 60, and 120 min after reperfusion of the graft, and 24 h and 7 days after LTx. A maximum mean concentration of 665 +/- 135 pg/ml was seen 60 min after LTx. The minimum was found on the 1st postoperative day (POD 1): 328 +/- 33 pg/ml. Significant changes were found between 60 min and PODs 1 and 7, as well as between 120 min and POD 1. Differences in cold ischemia time were not found to be significant. We conclude that monitoring of systemic IL-8 levels is not useful in the development of new liver preservation concepts.
- Published
- 1997
12. The isolated perfused porcine liver: assessment of viability during and after six hours of perfusion
- Author
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M. Adham, Simone Peyrol, Michèle Chevallier, Christian Ducerf, Michèle Vernet, Christine Barakat, Eric De La Roche, Abderrahmane Taibi, Thierry Bizollon, Dominic Rigal, Michel Pouyet, and Jacques Baulieux
- Subjects
Pathology ,medicine.medical_specialty ,Transplantation ,Time Factors ,medicine.diagnostic_test ,Swine ,business.industry ,Liver cell ,Hemodynamics ,Organ Preservation ,Perfusion ,Electrolytes ,medicine.anatomical_structure ,Liver ,Hepatocyte ,Animals ,Medicine ,Viaspan ,Lactic Acid ,Liver function ,business ,Liver function tests ,Oxygenator ,Liver preservation - Abstract
Isolated liver perfusion was developed for the study of liver physiology and preservation. The recent development of new perfusion devices and appropriate liver preservation solutions prompted us to reconsider liver perfusion for the specific purpose of evaluating viability in terms of biochemical changes, paying special attention to modifications in the histological ultrastructure. Twenty-two isolated pig livers were perfused with autologous blood. Arterio-portal perfusions were carried out using an extracorporeal perfusion circuit with a hollow fibre membrane oxygenator. Four groups of pig livers were studied using three different liver flushing solutions [Ringer's lactate, ELOHES, and University of Wisconsin (UW)] and two different oxygenation modalities. Liver function tests and histological studies were done. Our results revealed that a high partial oxygen pressure (PO2) level was deleterious to the ultrastructural elements of hepatocytes, in particular to the mitochondria. It was also associated with deficient metabolic performance, i. e., poor bile production and lack of aerobic metabolism. Normal blood gas values could be obtained with the use of air for liver oxygenation. Flushing of the liver with Ringer's lactate or a macromolecular solution such as ELOHES was associated with severe liver cell injuries, as reflected by a marked rise in liver enzymes and histological lesions. Satisfactory results were obtained when UW solution was used for liver harvesting. We conclude that an appropriate liver preservation solution, normal blood gas values, and normal physiological arterio-portal pressure and blood flow are essential for appropriate liver function with preservation of liver architecture and of hepatocyte ultrastructures. Total bilirubin in bile and Factor V are sensitive indicators of good liver function.
- Published
- 1997
13. Hyaluronic acid uptake in the assessment of sinusoidal endothelial cell damage after cold storage and normothermic reperfusion of rat livers
- Author
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Thomas M. van Gulik, Erik Endert, Marcel E. Reinders, Wilma M. Frederiks, Robert A. F. M. Chamuleau, Bart A. van Wagensveld, P. J. Klopper, and Other departments
- Subjects
Adenosine ,Allopurinol ,Organ Preservation Solutions ,Cold storage ,Biology ,Cold Ischemia Time ,Andrology ,chemistry.chemical_compound ,Raffinose ,Ischemia ,Lactate dehydrogenase ,medicine ,Animals ,Insulin ,Viaspan ,Endothelium ,Hyaluronic Acid ,Rats, Wistar ,Tromethamine ,Liver preservation ,Transplantation ,Temperature ,Organ Preservation ,Glutathione ,medicine.disease ,Rats ,Cold Temperature ,Oxygen ,Glucose ,Liver ,chemistry ,Biochemistry ,Reperfusion Injury ,Female ,Reperfusion injury ,Biomarkers - Abstract
The uptake of hyaluronic acid (HA) was used to assess preservation damage to sinusoidal endothelial cells (SEC) during cold storage and subsequent normothermic reperfusion of rat livers. After 8, 16, 24, and 48 h storage in University of Wisconsin (UW) solution, livers were gravity-flushed via the portal vein with a standard volume of cold UW solution containing 50 micrograms/l HA. The effluent was collected for analysis of HA, aspartate aminotransferase (AST), and lactate dehydrogenase (LDH). The mean uptake of HA at 0 h was 59.1% +/- 4.6% (mean +/- SEM). After 8 h of storage, HA uptake was similar (55.5% +/- 7.3%), whereas after 16 h of storage it was reduced to 34.7% +/- 5.8%. At 24 and 48 h of storage, no uptake of HA was found. In a second series of experiments, livers were stored in UW solution and subsequently reperfused for 90 min with a Krebs-Henseleit solution (37 degrees C) in a recirculating system containing 150 micrograms/l HA. Following 8 h of storage, 34.6% +/- 8.0% of the initial HA concentration was taken up from the perfusate. After 16 and 24 h of storage, no uptake of HA was found. The results of this study indicate that damage to SEC occurs progressively during storage, leading to zero uptake of HA by the rat livers at 24 h of cold ischemia time. Additional reperfusion injury to the SEC was demonstrated by the reduced ability of the SEC to take up HA following normothermic reperfusion. The uptake of exogenous HA in preserved livers, used as a tool to assess SEC injury, enables the detection of early preservation damage.
- Published
- 1996
14. Warm flush at 37 °C following cold storage attenuates reperfusion injury in preserved rat livers
- Author
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van Wagensveld, Bart A., Reinders, Marcel E., van Gulik, Thomas M., Gelderblom, Huub C., Frederiks, Wilma M., Wanders, Ronald J. A., and Obertop, Huug
- Published
- 1998
- Full Text
- View/download PDF
15. Comparison of solutions for preservation of the rabbit liver as tested by isolated perfusion
- Author
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Belzer Fo, D. C. Marsh, G. Den Butter, A. Saunder, and James H. Southard
- Subjects
Adenosine ,Allopurinol ,Organ Preservation Solutions ,Polyethylene glycol ,In Vitro Techniques ,Hydroxyethyl starch ,Potassium Chloride ,Andrology ,chemistry.chemical_compound ,Raffinose ,PEG ratio ,medicine ,Animals ,Insulin ,Mannitol ,Viaspan ,Aspartate Aminotransferases ,Liver preservation ,Transplantation ,Lagomorpha ,L-Lactate Dehydrogenase ,biology ,business.industry ,Organ Preservation ,biology.organism_classification ,Glutathione ,Perfusion ,Glucose ,Liver ,chemistry ,Biochemistry ,Sugar Phosphates ,Rabbits ,business ,Procaine ,medicine.drug - Abstract
The University of Wisconsin (UW) solution consists of a relatively complex mixture of agents. In this study we compared simpler preservation solutions, namely, histidine-tryptophan-ketoglutarate (HTK) and phosphate-buffered sucrose (PBS) with different compositions of UW solution in the isolated perfused rabbit liver model. Livers were stored cold for 24 and 48 h. After 24 h of preservation, the amount of bile produced in UW-preserved livers was significantly greater (P < 0.05) than that in HTK-preserved livers. Also, there was less LDH released into the perfusate in UW-preserved livers. There was more edema and lower K +/Na + rations in HTK-preserved livers than in UW-preserved livers (all data P < 0.05). After 48 h of preservation, the differences between livers preserved in UW or HTK solution were less noticeable than at 24 h and bile production was similar. LDH and AST release were greater in HTK-preserved livers than in UW livers, but these differences were not statistically significant. Preservation in PBS for 48 h was worse than in either UW or HTK solution. Substitution of polyethylene glycol (PEG) for hydroxyethyl starch (HES) in 48-h UW-preserved livers was not effective. We conclude that solutions simpler in composition than UW solution may be effective in kidney transplantation but do not appear suitable for successful liver preservation.
- Published
- 1995
16. Hypothermic perfusion preservation of liver: the role of phosphate in stimulating ATP synthesis studied by 31P NMR
- Author
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E Proctor, Barry Fuller, Christopher J. Lockett, and A.L. Busza
- Subjects
Male ,Magnetic Resonance Spectroscopy ,In Vitro Techniques ,Phosphates ,chemistry.chemical_compound ,Adenosine Triphosphate ,Hypothermia, Induced ,medicine ,Animals ,Rats, Wistar ,Raffinose ,Liver preservation ,Transplantation ,ATP synthase ,biology ,Organ Preservation ,Organ Size ,Nuclear magnetic resonance spectroscopy ,Phosphate ,Adenosine ,Liver Transplantation ,Rats ,Perfusion ,Liver ,chemistry ,Biochemistry ,biology.protein ,Biophysics ,Phosphorus Radioisotopes ,medicine.drug - Abstract
Hypothermic perfusion of rat livers was investigated by 31phosphorus nuclear magnetic resonance (31P NMR) spectroscopy using a temperature-controlled module that allowed data acquisition at various time points during a 48-h period. The livers were perfused with an oxygenated lactobionate/raffinose-based solution containing adenosine and inorganic phosphate, and changes in tissue oedema were monitored by direct on-line measurements of liver weight changes. Liver tissue ATP concentrations, determined by fluorimetric assay, were low immediately after organ removal, probably reflecting metabolic stress during the removal period, and these increased slightly during the next 3 h. This was reflected by changes in the 31P NMR spectra. However, by 24 h ATP levels had increased significantly, and these were maintained for up to 48 h, suggesting a shift in the balance between energy production and consumption. When inorganic phosphate was replaced by another anion (citrate), ATP was maintained at a constant lower level during perfusion for 48 h. Tissue weight changes were similar in both groups, suggesting that volume control was not affected by the different ATP contents of the livers. By combining the temperature-controlled module with a separate perfusion circuit, NMR spectroscopy can provide a sensitive method for following energy metabolism in the same organ over long periods during hypothermic perfusion.
- Published
- 1995
17. N-Acetylcysteine failed to improve early microcirculatory alterations of the rat liver after transplantation
- Author
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U. Flecks, Ingo Marzi, Felix Walcher, and Reinhard Larsen
- Subjects
Pathology ,medicine.medical_specialty ,medicine.medical_treatment ,Pharmacology ,Liver transplantation ,Rats, Sprague-Dawley ,Acetylcysteine ,Random Allocation ,chemistry.chemical_compound ,Cell Adhesion ,Leukocytes ,medicine ,Animals ,Lobules of liver ,Liver preservation ,chemistry.chemical_classification ,Transplantation ,Glutathione Disulfide ,business.industry ,Microcirculation ,Glutathione peroxidase ,Glutathione ,Liver Transplantation ,Rats ,Liver ,chemistry ,Reperfusion Injury ,Glutathione disulfide ,Female ,business ,Intravital microscopy ,medicine.drug - Abstract
The application of radical scavengers reduces reperfusion injury of liver grafts despite the natural occurrence of cellular defense mechanisms enabling the cell to tolerate moderate oxidant stress without further cell damage. The glutathione peroxidase mechanism of the liver serves to reduce hydroxyl radical-induced lipid peroxidation by releasing reduced glutathione from intracellular stores. There is evidence that the application of cysteine-providing aminoacids for glutathione synthesis could maintain or even increase liver glutathione. Therefore, the purpose of this study was to evaluate the effect of N-acetylcysteine (NAC) on oxidative stress-induced reperfusion injury after liver transplantation. This was done by applying intravital microscopy. Livers from female Sprague-Dawley rats weighing 220–260 g were stored for 20 h in University of Wisconsin (UW) solution and transplanted orthotopically using the cuff technique. Donors were given 150 mg/kg body weight NAC i. v. or placebo in a blind, random fashion 6 h prior to harvesting, followed by two injections of 50 mg/kg body weight, 4 and 2 h before explantation. In additional experimental groups, recipients were given a bolus of 83 mg/kg body weight NAC or placebo at the beginning of the recipient operations, 1 min prior to reperfusion, and 60 min after surgery. Ninety minutes after transplantation, intravital microscopy was applied and five liver lobules were recorded for 30 s after injection of acridine orange, a fluorescent leukocyte marker. Sinusoidal perfusion, sinusoidal width, and leukocyte adhesion, as well as reduced and oxidized glutathione, were determined in all livers. Neither microcirculatory disturbance nor leukocyte adhesion was less, nor was the liver glutathione in the recipient groups pretreated or treated with NAC greater than that in rats receiving the placebo. Moreover, liver glutathione was significantly decreased in livers from donors pretreated with NAC. In conclusion, the application of NAC as a pretreatment for donors and as treatment for recipients, respectively, failed to reduce early microvascular failure after liver transplantation.
- Published
- 1995
18. Venous air embolism, preservation/reperfusion injury, and the presence of intravascular air collections in human donor livers: a retrospective clinical study
- Author
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R. Verwer, A. Ballast, R.F.E. Wolf, Maarten J.H. Slooff, Wj Sluiter, and R.M. van Dam
- Subjects
Nephrology ,AIR COLLECTION ,medicine.medical_specialty ,medicine.medical_treatment ,Hemodynamics ,Liver transplantation ,Air embolism ,Veins ,Internal medicine ,medicine ,Embolism, Air ,Humans ,Liver preservation ,Retrospective Studies ,Transplantation ,business.industry ,Vascular disease ,LIVER PRESERVATION ,medicine.disease ,Magnetic Resonance Imaging ,Liver Transplantation ,Surgery ,Liver ,Reperfusion Injury ,Tissue Preservation ,business ,Reperfusion injury ,MRI - Abstract
In human liver transplantation, air embolism is seldom encountered after graft reperfusion. Nevertheless, despite adequate flushing and clamping routines, air emboli have been reported in transesophageal echocardiography (TEE) studies performed during the reperfusion phase, We retrospectively investigated whether air in the donor liver - as observed with pre transplant magnetic resonance imaging (MRI) - resulted in clinical air embolism or contributed to preservation/reperfusion injury, Clinical air embolism was assessed by intraoperative hemodynamics and end-tidal CO, monitoring. Preservation/reperfusion injury was assessed in postoperative biochemical measurements. The outcomes were compared between patients receiving livers containing significant intrahepatic air and patients receiving livers without intrahepatic air. Forty-three livers were studied, seven of which had major intrahepatic air and ten of which had no evidence of air collections. Twenty-six livers showed minor amounts of air and were excluded from further study. One patient who received a liver that did not contain intrahepatic air had clinical evidence of air embolism. Clinical air embolism did not appear to be associated with the presence of significant intrahepatic air based upon pretransplant MRI. Intrahepatic air did not seem to affect the amount of preservation/reperfusion injury. Our data indicate that air bubbles in the portal and arterial branches are absorbed during reperfusion and that the majority of intrahepatic air is effectively removed by the specific flushing routines.
- Published
- 1995
19. Systemic liberation of interleukin-8 in the perioperative phase of liver transplantation
- Author
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Gerlach, J., Jörres, Achim, Schön, Michael, Nohr, Roland, Berger, Axel, Spatkowski, Gabriele, Smith, Mark D., and Neuhaus, Peter
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- 1997
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20. Comparison of histidine-tryptophan-ketoglutarate (HTK) solution versus University of Wisconsin (UW) solution for organ preservation in human liver transplantation
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M. M. Gebhard, J. Erhard, Wolfgang J. Kox, R. Scherer, H. J. Bretschneider, R. Lange, and F. W. Eigler
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Adult ,Male ,medicine.medical_specialty ,Adenosine ,Adolescent ,Allopurinol ,medicine.medical_treatment ,Organ Preservation Solutions ,Liver transplantation ,030230 surgery ,Cold Ischemia Time ,Gastroenterology ,Potassium Chloride ,Histidine-tryptophan-ketoglutarate ,Liver disease ,03 medical and health sciences ,Raffinose ,0302 clinical medicine ,Liver Function Tests ,Internal medicine ,Humans ,Insulin ,Medicine ,Mannitol ,Viaspan ,Prospective Studies ,Cardioplegic Solutions ,Liver preservation ,Aged ,Transplantation ,medicine.diagnostic_test ,business.industry ,Graft Survival ,Organ Preservation ,Middle Aged ,medicine.disease ,Glutathione ,Liver Transplantation ,3. Good health ,Glucose ,Liver ,Female ,030211 gastroenterology & hepatology ,business ,Liver function tests ,Procaine - Abstract
Over a 30-month period, 60 patients (30 in each group) suffering from end-stage liver disease or primary hepatic malignancy and scheduled for liver transplantation were enrolled in a prospective, randomized study to compare two methods of liver preservation: histidine-tryptophan-ketoglutarate (HTK) solution versus University of Wisconsin (UW) solution. Entry criteria for both groups were: age (18-65 years), elective surgery (transplantable or urgent category of the recipients), first transplantations and harvesting procedure performed by the same team. The parameters under investigation were the clinical and laboratory data pre- and post-transplantation, as well as follow-up data such as complications and survival. There were no significant differences in the two groups as far as the evaluation criteria were concerned, even when cold ischemia time was more than 15 h (n = 7). A slight, yet not significant, increase in late complications of the biliary anastomoses could be seen in the UW group. Hepatocellular injury (SGOT, SGPT, GLDH, lactate) appeared to be more marked in the HTK group. These results suggest that both HTK and UW solutions are appropriate for clinical use in liver transplantation, even if cold ischemia time is more than 15 h.
- Published
- 1994
21. N-Acetylcysteine failed to improve early microcirculatory alterations of the rat liver after transplantation
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Walcher, F., Marzi, I., Flecks, U., and Larsen, R.
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- 1995
- Full Text
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22. Protective effects of the lazaroid U74500A and lidoflazine on liver preservation with UW solution
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Thomas E. Starzl, Alessandro Gasbarrini, H. L. R. Rilo, Jeanette Jacobsson, D. H. Van Thiel, and R. Sundberg
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Male ,Lipid Peroxides ,Adenosine ,Allopurinol ,medicine.medical_treatment ,Organ Preservation Solutions ,Liver transplantation ,Pharmacology ,Article ,Raffinose ,medicine ,Animals ,Insulin ,Viaspan ,Aspartate Aminotransferases ,Pregnatrienes ,Liver preservation ,Lidoflazine ,Transplantation ,L-Lactate Dehydrogenase ,biology ,business.industry ,Antagonist ,Alanine Transaminase ,Organ Preservation ,medicine.disease ,Glutathione ,Rats ,Liver ,Alanine transaminase ,Biochemistry ,Rats, Inbred Lew ,Reperfusion Injury ,biology.protein ,business ,Reperfusion injury ,medicine.drug - Abstract
The effect of adding a 21-aminosteroid, U74SOOA, and a Ca2+ antagonist, lidoflazine, alone and together to UW solution was assessed in a rat liver preservation model. Following preservation, the lives were reperfused using a closed circuit, and the release of hepato-cellular enzymes (ASAT, ALAT, and LDH) into the perfusate was determined with increasing time. Both drugs reduced the amount of enzymes lost from the liver. The combination of the two drugs was better than either drug alone. These data suggest that both agents may be of value in organ preservation for clinical liver transplantation.
- Published
- 1993
23. Effect of prostaglandin E1 on preservation injury of canine liver grafts preserved in UW solution
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Kazue Ozawa, Y. Takada, K. Mori, T. Takeuchi, Hiroto Egawa, Naritaka Yamamoto, Fumio Nishizawa, Takashi Takayasu, Keiichi Takahashi, Yamaguchi T, M. Narita, and Yoshio Yamaoka
- Subjects
medicine.medical_specialty ,Adenosine ,Time Factors ,Necrosis ,Allopurinol ,Organ Preservation Solutions ,Ischemia ,Ketone Bodies ,chemistry.chemical_compound ,Dogs ,Raffinose ,medicine ,Animals ,Insulin ,Viaspan ,Aspartate Aminotransferases ,Alprostadil ,Prostaglandin E1 ,Liver preservation ,Guanine Deaminase ,Transplantation ,L-Lactate Dehydrogenase ,biology ,business.industry ,Fissipedia ,Organ Preservation ,respiratory system ,medicine.disease ,biology.organism_classification ,Glutathione ,Liver Transplantation ,Surgery ,Liver ,chemistry ,Reperfusion Injury ,Anesthesia ,Ketone bodies ,lipids (amino acids, peptides, and proteins) ,medicine.symptom ,business ,circulatory and respiratory physiology - Abstract
This study investigated whether prostaglandin E1 (PGE1) could reduce hepatic injury to the liver graft caused by harvesting and 24-h preservation in University of Wisconsin (UW) solution in a canine model. The PGE1-treated group was intravenously administered 0.5 microgram/kg per minute of PGE1 for 30 min before harvesting, as well as a concentration of 1 mg/l PGE1 in the washout and UW solutions. In both the PGE1-treated and the control group, all recipients survived for 1 week or more after transplantation. Arterial ketone body ratio (AKBR) remained over 1.0 in the early postoperative period. The PGE1 group showed significant reductions in guanase, GOT, and LDH during the early postoperative period compared to the untreated control group. Histological examination disclosed partial mitochondrial swelling, hepatocyte vacuolation, and necrosis in the control group, while such abnormalities were rarely seen in the PGE1 group. These results suggest that PGE1 can effectively reduce hepatic injury to liver grafts preserved in UW solution prior to transplantation.
- Published
- 1993
24. An in vitro method for comparing the efficacy of two preservation solutions in one canine liver using the 5′-nucleotidase assay
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C. R. Nio, T.M. van Gulik, P. J. Klopper, M. N. Van Der Heyde, Wilma M. Frederiks, Surgery, and AGEM - Amsterdam Gastroenterology Endocrinology Metabolism
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Pathology ,medicine.medical_specialty ,Adenosine ,Liver preservation, 5′-nucleotidase ,Allopurinol ,Preservation, liver ,medicine.medical_treatment ,Hypertonic Solutions ,Organ Preservation Solutions ,Urology ,liver ,5'-nucleotidase ,Dogs ,Raffinose ,Ischemia ,Nucleotidase ,Carnivora ,Animals ,Insulin ,Medicine ,Viaspan ,Aspartate Aminotransferases ,5'-Nucleotidase ,Liver preservation ,Transplantation ,biology ,business.industry ,Graft Survival ,Fissipedia ,Organ Preservation ,biology.organism_classification ,Glutathione ,In vitro ,Preservation ,Liver Transplantation ,Solutions ,5′-Nucleotidase, liver preservation ,Female ,Hepatectomy ,5′-nucleotidase ,business - Abstract
The activity and localization of the plasma membrane-bound enzyme 5′-nucleotidase (5′-NT) in liver tissue are sensitive parameters of ischemic damage. The value of 5′-NT as a marker of liver graft viability was studied in relation to liver preservation. In six mongrel dogs, the main right and left branches of the portal vein were cannulated and flushed separately in situ with cold University of Wisconsin (UW) solution and Euro-Collins (EC) solution, respectively. After hepatectomy, the right and left liver lobes were split and stored at 5°C in either of the two solutions. 5′-NT activity was demonstrated in cryostat sections of liver tissue using the lead salt method. After 48 h of storage in EC solution, the 5′-NT score had decreased to 31%±16% (n=6), whereas in UW solution the 5′-NT score was 76%±10% (n=6). Significantly (P5 days). pretransplant 5′-NT scores ranged from 61% to 100%. The 72-h-preserved livers (n=5) did not show life-supporting function. Pretransplant 5′-NT scores (33%±12%, n=5) were significantly (P
- Published
- 1993
25. Comparison of University of Wisconsin (UW) and Eurocollins (EC) preservation solutions in a rat liver transplant model
- Author
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Ruud A.F. Krom, Deanna M. Ferguson, R. Steffen, and J. Ludwig
- Subjects
medicine.medical_specialty ,Adenosine ,Time Factors ,Orthotopic liver transplantation ,Allopurinol ,medicine.medical_treatment ,Hypertonic Solutions ,Organ Preservation Solutions ,Aspartate transaminase ,Liver transplantation ,Andrology ,Hepatic Artery ,Raffinose ,medicine ,Preservation solutions ,Animals ,Insulin ,Liver preservation ,Severe ischemia ,Transplantation ,biology ,business.industry ,Anastomosis, Surgical ,Organ Preservation ,Organ Size ,Glutathione ,Liver Transplantation ,Rats ,Surgery ,Solutions ,Liver ,Rat liver ,biology.protein ,Hepatectomy ,business - Abstract
The Eurocollins (EC) and University of Wisconsin (UW) preservation solutions were compared in a rat liver transplant model. After hepatectomy, 48 rat livers were flushed with either EC or UW preservation solution and were randomly assigned to 1, 12, 24, and 30 h of preservation at 4 degrees C, resulting in eight groups each containing six livers. Following preservation, orthotopic liver transplantation with reconstruction of the hepatic artery was performed. The efficacy of the preservation solution was assessed at 48 h post-transplantation by survival histological features and aspartate transaminase assay (AST) values. None of the rats survived 30 h of liver preservation with EC whereas five out of six rats did with UW preservation. After 24 h of liver preservation, three of the six rats in the EC group survived, compared to all six rats in the UW group. Histological evidence of severe ischemia was found in both groups in all but one survivor (UW, 24 h). After 12 h of EC preservation, one rat died within 48 h and severe ischemic changes were found in the remaining five rats. Among the rats with 12 h of UW preservation, only two out of six showed ischemic changes, and all six rats survived beyond 48 h. Without preservation (1 h), ischemic damage was found in two out of six rats in each group and all rats survived. The median AST values were higher in the EC groups than in the UW groups; the difference became significant after 12-h preservation (EC 900 IU/l versus UW 465 IU/l) and 24-h preservation (EC 5220 IU/l versus UW 631 IU/l).(ABSTRACT TRUNCATED AT 250 WORDS)
- Published
- 1990
26. Rat liver preservation
- Author
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D. Coddington, Yu W, and H. Bitter-Suermann
- Subjects
Transplantation ,Pathology ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Cold storage ,Liver transplantation ,Pharmacology ,Eurocollins solution ,Rat liver ,medicine ,Viaspan ,Isotonic Solutions ,Ringer's lactate ,business ,Liver preservation - Abstract
The mechanisms by which cold preservation solutions exert their protective effects are only partially understood. The consequences of mixing different solutions, with presumably different modes of action, may be additive and beneficial or may be deleterious. It is commonplace in clinical liver preservation to use Ringer's lactate (RL), Eurocollins (EC), and University of Wisconsin (UW) solution in sequence for washout of blood, precooling, and cold storage of the organ. In this study, 114 Sprague Dawley rats received orthotopic liver transplants that were flushed in various sequences with RL, EC, and UW solutions. One-week animal survival served as the criterion of preservation success. The results demonstrated that liver preservation with UW solution alone is significantly superior (P less than 0.01) to any combination of RL, EC, and UW solutions and may explain some of the instances of primary nonfunction in clinical liver transplantation.
- Published
- 1990
27. The influence of an improved preservation solution On prognostic factors for graft survival in pediatric liver transplantation
- Author
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Pmjg Peeters, Mjh Slooff, RP Bleichrodt, S. Pisarski, Cma Bijleveld, and EM TenVergert
- Subjects
Transplantation ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,LIVER PRESERVATION ,030230 surgery ,Liver transplantation ,Surgery ,03 medical and health sciences ,surgical procedures, operative ,0302 clinical medicine ,GRAFT SURVIVAL ,PROGNOSTIC FACTORS ,Medicine ,030211 gastroenterology & hepatology ,Graft survival ,business ,Liver preservation ,UW/EC PRESERVATION SOLUTION - Abstract
We investigated the influence of Eurocollins (EC) and University of Wisconson solution (UW) on prognostic factors for graft survival after pediatric liver transplantation. The 1-year graft survival was studied for 30 patients in which 38 transplantations were performed between 1982 and 1988. We preserved 19 grafts in EC and the other 19 grafts in UW solution. For grafts preserved in EC, the median preservation time was 5 h compared to 10.8 h for grafts preserved in UW solution (P
- Published
- 1992
28. Why is liver preservation performed at 4°C?
- Author
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Kazuhiko Seya, Nobuhiro Ohkohchi, Susumu Satomi, and Shigeki Tsukamoto
- Subjects
Proton ATPase ,Transplantation ,ATP synthase ,biology ,Xanthine ,Adenosine ,chemistry.chemical_compound ,chemistry ,Biochemistry ,Adenine nucleotide ,medicine ,biology.protein ,Viaspan ,Liver preservation ,Hypoxanthine ,medicine.drug - Abstract
To establish the most suitable temperature for liver preservation, we preserved rat livers at various temperatures (0, 5, 10, and 15 °C) in UW solution and investigated, biochemically, the proton ATPase activity, ATP metabolites in mitochondria, and phosphatidylcholine hydroperoxide (PC-OOH) in liver tissue. Liver specimens were taken every 6 h up to 24 h. The proton ATPase activity and the concentration of ATP, ADP, AMP, and adenosine in livers preserved at 0 °C showed the best results. The total adenine nucleotide (TAN) in livers preserved for 18 and 24 h had significantly higher concentrations compared with those at other temperatures (5, 10, and 15 °C). In the livers preserved at 5 °C, TAN was degraded to hypoxanthine. On the other hand, those preserved at both 10 and 15 °C showed changes from hypoxanthine to xanthine. The concentration of xanthine in both groups preserved at 10 and 15 °C showed high values at 6 and 12 h, respectively, and similar changes in PC-OOH concentrations at both 10 and 15 °C were observed. However, the changes in PC-OOH concentration at various temperatures were not significant for any length of preservation time. In light microscopical examinations, there were no morphological changes in the hepatocytes. From these results, we conclude that the capability of ATP synthesis of mitochondria in livers preserved at 0 °C keep them in the best condition compared with livers preserved at 15, 10, and 5 °C.
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29. Systemic liberation of interleukin-1? and interleukin-1 receptor antagonist in the perioperative phase of liver transplantation
- Author
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Axel Berger, Michael R. Schön, Achim Jörres, Jörg C. Gerlach, Roland Nohr, Mark A. Smith, and Peter Neuhaus
- Subjects
Adult ,Male ,medicine.medical_specialty ,Pathology ,Time Factors ,Neutrophils ,medicine.drug_class ,Sialoglycoproteins ,medicine.medical_treatment ,Liver transplantation ,Gastroenterology ,Monocytes ,Intraoperative Period ,Internal medicine ,Humans ,Medicine ,Postoperative Period ,Interleukin 6 ,Liver preservation ,Transplantation ,biology ,Interleukin-6 ,Tumor Necrosis Factor-alpha ,business.industry ,Macrophages ,Antagonist ,Interleukin ,Middle Aged ,Receptor antagonist ,Liver Transplantation ,Interleukin 1 Receptor Antagonist Protein ,Interleukin 1 receptor antagonist ,biology.protein ,Female ,Endothelium, Vascular ,Secretory Rate ,business ,Interleukin-1 - Abstract
We measured systemic serum levels of interleukin-1 receptor antagonist (IL-1ra), interleukin-1 beta (IL-1 beta), tumor necrosis factor alpha (TNF-alpha), and interleukin-6 (IL-6) during the preoperative, anhepatic, and postreperfusional phases up to the 7th postoperative day in 60 patients undergoing orthotopic liver transplantation (LTx). In contrast to IL-1 beta, IL-1ra, TNF-alpha, and IL-6 showed a significant elevation in relation to the early phase after reperfusion, while TNF-alpha displayed a high grade of scatter. In addition, IL-1ra levels were significantly elevated during the anhepatic phase. Maximum serum levels were found at 15 min after reperfusion, 120 min after reperfusion, and on the 1st postoperative day, respectively. Serum levels decreased considerably at 24 h and 7 days after reperfusion. The comparative monitoring of systemic cytokine and cytokine antagonist levels, in particular the liberation of IL-1ra and IL-6 may provide useful parameters for the development of new liver preservation theories for LTx.
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30. Postoperative recovery of mitochondrial function of the human liver graft procured and preserved with University of Wisconsin (UW) solution
- Author
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Ernst R. Kuse, Hartwig Bunzendahl, M. Oellerich, Pichlmayr R, G. Gubernatis, Shinji Uemoto, Yoshiro Taki, N. Osaki, B. Ringe, Yoshio Yamaoka, Kazue Ozawa, Kimoto M, and M. Burdelski
- Subjects
medicine.medical_specialty ,Adenosine ,Time Factors ,medicine.medical_treatment ,Allopurinol ,Hypertonic Solutions ,Organ Preservation Solutions ,Urology ,Mitochondria, Liver ,Postoperative recovery ,Ketone Bodies ,Liver transplantation ,Raffinose ,Liver Function Tests ,medicine ,Humans ,Insulin ,Cold preservation ,Viaspan ,Postoperative Period ,Liver preservation ,Transplantation ,Human liver ,medicine.diagnostic_test ,business.industry ,Organ Preservation ,Glutathione ,Surgery ,Liver Transplantation ,Solutions ,Arterial blood ,Liver function tests ,business - Abstract
Changes in arterial blood ketone body ratio (KBR) were investigated in 47 human liver transplantations. Of the 20 grafts preserved with University of Wisconsin (UW) solution, 10 had a cold preservation period of less than 10 h (UWS group) and 10 of more than 10 h (UWL group). In 27 other cases, grafts were preserved with EuroCollins (EC) solution for less than 10 h (EC group). In the EC group, KBR increased over 0.7 within 6 h after reperfusion of the graft in 17 cases (63%) and within 24 h in 7 cases (26%). In the 3 other cases, KBR failed to recover, and these patients underwent retransplantation. In the UW group, KBR recovered within 6 h in 13 cases (65%) and within 24 h in 7 cases (35%). There were no significant differences between the UWS and UWL groups. It is shown that the mitochondrial function of liver grafts preserved with UW solution can be well maintained even after extended preservation periods of more than 10 h.
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31. Effect of cold aerobic perfusion on nonparenchymal cell viability of rat livers
- Author
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Yoko Maekawa, Yoshikazu Kuroda, Masahiro Tominaga, Yoichi Saitoh, Masahiro Samizo, Hiromoto Shiki, Takumi Fukumoto, Yonson Ku, and Tokihito Nishida
- Subjects
Male ,Adenosine ,Cell Survival ,Bicarbonate ,Allopurinol ,Organ Preservation Solutions ,Hydroxyethyl starch ,Andrology ,Rats, Sprague-Dawley ,chemistry.chemical_compound ,Raffinose ,Blood Substitutes ,Medicine ,Animals ,Insulin ,Viaspan ,Viability assay ,Liver preservation ,Fluorocarbons ,Transplantation ,business.industry ,Oxygenation ,Trypan Blue ,Isoquinolines ,Glutathione ,Aerobiosis ,Rats ,Perfusion ,chemistry ,Biochemistry ,Liver ,Reperfusion ,Trypan blue ,business ,medicine.drug - Abstract
We investigated the effect of oxygen supply on hepatic cellular viability during cold perfusion storage of rat livers. A perfluoro-N-methyldecahydroisoquinoline (FMIQ) emulsion is used as an oxygen carrier. The composition of the perfusate containing 20 w/v% FMIQ is essentially the same as the University of Wisconsin (UW) solution except for the exclusion of hydroxyethyl starch. Rat livers were perfused at 4 degrees C for up to 24 h with either UW solution (group I, oxygenated; group II, unoxygenated) or FMIQ solution (group III, oxygenated; group IV, unoxygenated). After perfusion storage, the livers were reperfused with warm (37 degrees C) oxygenated or cold (4 degrees C) unoxygenated Krebs-Henseleit bicarbonate buffer, and nuclear trypan blue uptake was measured as the index of cell death. With warm oxygenated reperfusion, there remained less than 2% noviable parenchymal cells up to 24 h, regardless of perfusate or oxygenation. In UW-perfused livers, the proportion of nonviable nonprenchymal cells (NPC) increased progressively regardless of oxygenation, the values in groups I and II in the periportal field at 24 h being 39.9 +/- 4.7% (mean +/- SD) and 36.5 +/- 4.2%, respectively. By contrast, in FMIQ-perfused livers, dye uptake by NPC was significantly reduced with oxygenation (16.9 +/- 5.7% and 39.4% +/- 9.1% at 24 h in groups III and IV; P < 0.001). With cold unoxygenated reperfusion, livers in groups I, II, and IV showed a significant decrease of nonviable NPC, while those in group III showed no significant changes. These data indicate that oxygen supply during perfusion storage of the liver may ameliorate lethal injury to NPC precipitated during reperfusion.
- Full Text
- View/download PDF
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