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Prediction of Graft Viability from Non-Heart-Beating Donor Pigs Using Hepatic Microdialysate Hypoxanthine Levels

Background. Non-heart-beating donors (NHBDs) are not yet acceptable in orthotopic liver transplantation (OLTX) because of the high frequency of primary graft nonfunction. In this study, we aimed to develop a new predictive method of graft viability in OLTX from NHBDs. Materials and methods. (1) Pigs...

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Published in:The Journal of surgical research 2002-10, Vol.107 (2), p.210-218
Main Authors: Nagayama, Minoru, Katsuramaki, Tadashi, Kimura, Hitoshi, Isobe, Masato, Meguro, Makoto, Matsuno, Takashi, Nui, Akihiro, Hirata, Koichi
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cited_by cdi_FETCH-LOGICAL-c370t-37874257676603a3aeb201c3454786a173639d5751a0fd7094ebabb2ef8c578c3
cites cdi_FETCH-LOGICAL-c370t-37874257676603a3aeb201c3454786a173639d5751a0fd7094ebabb2ef8c578c3
container_end_page 218
container_issue 2
container_start_page 210
container_title The Journal of surgical research
container_volume 107
creator Nagayama, Minoru
Katsuramaki, Tadashi
Kimura, Hitoshi
Isobe, Masato
Meguro, Makoto
Matsuno, Takashi
Nui, Akihiro
Hirata, Koichi
description Background. Non-heart-beating donors (NHBDs) are not yet acceptable in orthotopic liver transplantation (OLTX) because of the high frequency of primary graft nonfunction. In this study, we aimed to develop a new predictive method of graft viability in OLTX from NHBDs. Materials and methods. (1) Pigs were subjected to 15 min of hepatic ischemia and reperfusion (I/R). (2) Porcine OLTX was performed using grafts obtained from NHBDs subjected to in situ warm ischemia (0, 30, and 60 min). During both operations, hepatic hypoxanthine levels were measured by a microdialysis method. Results. In the I/R model, hypoxanthine accumulated during ischemia and decreased after reperfusion, whereas marked xanthine and uric acid production were observed after reperfusion. In the NHBDs model, all of the 0-min group, 6 of 13 pigs in the 30-min group, and 1 of 6 pigs in the 60-min group survived more than 7 days. Significant increases of hypoxanthine levels were seen dependent on warm ischemic time. In the 30-min group, hypoxanthine levels were significantly higher in the pigs that died than in those that survived, and correlated with aspartate aminotransferase, lactate dehydrogenase, and adenosine triphosphate levels of recipients. Histological examination revealed that graft injury was severe in the pigs with higher hypoxanthine levels. Conclusions. It is suggested that hepatic microdialysate hypoxanthine levels during warm ischemia in NHBDs were correlated with graft viability in the recipient. By using of this technique, prediction of the graft viability may be possible during donor operation.
doi_str_mv 10.1006/jsre.2002.6514
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Non-heart-beating donors (NHBDs) are not yet acceptable in orthotopic liver transplantation (OLTX) because of the high frequency of primary graft nonfunction. In this study, we aimed to develop a new predictive method of graft viability in OLTX from NHBDs. Materials and methods. (1) Pigs were subjected to 15 min of hepatic ischemia and reperfusion (I/R). (2) Porcine OLTX was performed using grafts obtained from NHBDs subjected to in situ warm ischemia (0, 30, and 60 min). During both operations, hepatic hypoxanthine levels were measured by a microdialysis method. Results. In the I/R model, hypoxanthine accumulated during ischemia and decreased after reperfusion, whereas marked xanthine and uric acid production were observed after reperfusion. In the NHBDs model, all of the 0-min group, 6 of 13 pigs in the 30-min group, and 1 of 6 pigs in the 60-min group survived more than 7 days. Significant increases of hypoxanthine levels were seen dependent on warm ischemic time. In the 30-min group, hypoxanthine levels were significantly higher in the pigs that died than in those that survived, and correlated with aspartate aminotransferase, lactate dehydrogenase, and adenosine triphosphate levels of recipients. Histological examination revealed that graft injury was severe in the pigs with higher hypoxanthine levels. Conclusions. It is suggested that hepatic microdialysate hypoxanthine levels during warm ischemia in NHBDs were correlated with graft viability in the recipient. By using of this technique, prediction of the graft viability may be possible during donor operation.</description><identifier>ISSN: 0022-4804</identifier><identifier>EISSN: 1095-8673</identifier><identifier>DOI: 10.1006/jsre.2002.6514</identifier><identifier>PMID: 12429177</identifier><identifier>CODEN: JSGRA2</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adenosine Triphosphate - analysis ; Alanine Transaminase - blood ; Animals ; Biological and medical sciences ; Diseases of the digestive system ; Female ; Graft Survival ; hypoxanthine ; Hypoxanthine - analysis ; Ischemia - metabolism ; ischemia/reperfusion injury ; L-Lactate Dehydrogenase - blood ; Liver - blood supply ; Liver - metabolism ; Liver - pathology ; Liver Transplantation - methods ; Medical sciences ; Microdialysis ; non-heart-beating donors ; orthotopic liver transplantation ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. 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Non-heart-beating donors (NHBDs) are not yet acceptable in orthotopic liver transplantation (OLTX) because of the high frequency of primary graft nonfunction. In this study, we aimed to develop a new predictive method of graft viability in OLTX from NHBDs. Materials and methods. (1) Pigs were subjected to 15 min of hepatic ischemia and reperfusion (I/R). (2) Porcine OLTX was performed using grafts obtained from NHBDs subjected to in situ warm ischemia (0, 30, and 60 min). During both operations, hepatic hypoxanthine levels were measured by a microdialysis method. Results. In the I/R model, hypoxanthine accumulated during ischemia and decreased after reperfusion, whereas marked xanthine and uric acid production were observed after reperfusion. In the NHBDs model, all of the 0-min group, 6 of 13 pigs in the 30-min group, and 1 of 6 pigs in the 60-min group survived more than 7 days. Significant increases of hypoxanthine levels were seen dependent on warm ischemic time. In the 30-min group, hypoxanthine levels were significantly higher in the pigs that died than in those that survived, and correlated with aspartate aminotransferase, lactate dehydrogenase, and adenosine triphosphate levels of recipients. Histological examination revealed that graft injury was severe in the pigs with higher hypoxanthine levels. Conclusions. It is suggested that hepatic microdialysate hypoxanthine levels during warm ischemia in NHBDs were correlated with graft viability in the recipient. By using of this technique, prediction of the graft viability may be possible during donor operation.</description><subject>Adenosine Triphosphate - analysis</subject><subject>Alanine Transaminase - blood</subject><subject>Animals</subject><subject>Biological and medical sciences</subject><subject>Diseases of the digestive system</subject><subject>Female</subject><subject>Graft Survival</subject><subject>hypoxanthine</subject><subject>Hypoxanthine - analysis</subject><subject>Ischemia - metabolism</subject><subject>ischemia/reperfusion injury</subject><subject>L-Lactate Dehydrogenase - blood</subject><subject>Liver - blood supply</subject><subject>Liver - metabolism</subject><subject>Liver - pathology</subject><subject>Liver Transplantation - methods</subject><subject>Medical sciences</subject><subject>Microdialysis</subject><subject>non-heart-beating donors</subject><subject>orthotopic liver transplantation</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. 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Non-heart-beating donors (NHBDs) are not yet acceptable in orthotopic liver transplantation (OLTX) because of the high frequency of primary graft nonfunction. In this study, we aimed to develop a new predictive method of graft viability in OLTX from NHBDs. Materials and methods. (1) Pigs were subjected to 15 min of hepatic ischemia and reperfusion (I/R). (2) Porcine OLTX was performed using grafts obtained from NHBDs subjected to in situ warm ischemia (0, 30, and 60 min). During both operations, hepatic hypoxanthine levels were measured by a microdialysis method. Results. In the I/R model, hypoxanthine accumulated during ischemia and decreased after reperfusion, whereas marked xanthine and uric acid production were observed after reperfusion. In the NHBDs model, all of the 0-min group, 6 of 13 pigs in the 30-min group, and 1 of 6 pigs in the 60-min group survived more than 7 days. Significant increases of hypoxanthine levels were seen dependent on warm ischemic time. In the 30-min group, hypoxanthine levels were significantly higher in the pigs that died than in those that survived, and correlated with aspartate aminotransferase, lactate dehydrogenase, and adenosine triphosphate levels of recipients. Histological examination revealed that graft injury was severe in the pigs with higher hypoxanthine levels. Conclusions. It is suggested that hepatic microdialysate hypoxanthine levels during warm ischemia in NHBDs were correlated with graft viability in the recipient. By using of this technique, prediction of the graft viability may be possible during donor operation.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>12429177</pmid><doi>10.1006/jsre.2002.6514</doi><tpages>9</tpages></addata></record>
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subjects Adenosine Triphosphate - analysis
Alanine Transaminase - blood
Animals
Biological and medical sciences
Diseases of the digestive system
Female
Graft Survival
hypoxanthine
Hypoxanthine - analysis
Ischemia - metabolism
ischemia/reperfusion injury
L-Lactate Dehydrogenase - blood
Liver - blood supply
Liver - metabolism
Liver - pathology
Liver Transplantation - methods
Medical sciences
Microdialysis
non-heart-beating donors
orthotopic liver transplantation
Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
Reperfusion
Swine
title Prediction of Graft Viability from Non-Heart-Beating Donor Pigs Using Hepatic Microdialysate Hypoxanthine Levels
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