2000 Fiscal Year Final Research Report Summary
Estimation of Graft Viability before Reperfusion Using Hepatic Microdialysate Hypoxanthine Levels in Porcine Liver Transplantation from Non-Heart-Beating Donors
| Project/Area Number |
11557094
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| Research Category |
Grant-in-Aid for Scientific Research (B).
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| Allocation Type | Single-year Grants |
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| Section | 展開研究 |
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| Research Field |
Digestive surgery
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| Research Institution | Sapporo Medical University |
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Principal Investigator |
KATSURAMAKI Tadashi School of medicine, Sapporo Medical University Assistant professor, 医学部, 講師 (50253993)
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| Co-Investigator(Kenkyū-buntansha) |
OUMURA Tousei School of medicine, Sapporo Medical University Asociate professor, 医学部, 助手 (30295349)
MUKAIYA Mitsuhiro School of medicine, Sapporo Medical University Assistant professor, 医学部, 講師 (00253998)
HIRATA Koichi School of medicine, Sapporo Medical University Professor, 医学部, 教授 (50136959)
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| Project Period (FY) |
1999 – 2000
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| Keywords | liver transplantation / ischemia / reperfusion injury / non-heart-beating donors / microdialysate / hypoxanthine |
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| Research Abstract |
Non-heart-beating donors (NHBDs) are being considered for grafts in orthotopic liver transplantation (OLTX), but are not yet acceptable because of the high frequency of primary nonfunction. To establish successful liver engraftment, new strategies are needed. The aim of this study was to explore the usefull of monitoring hepatic microdialysate hypoxanthine levels during warm ischemia in cardiac arrest donors to assess liver viability before transplantation. Porcine OLTX was performed using grafts obtained from NHBDs subjected to in situ warm ischemia (0, 30 and 60 min). In the donor operation, hepatic interstitial hypoxanthine levels were measured during warm ischemia by a microdialysis method. All of the 0-min group, 6 of 13 pigs in the 30-min group, and 1 of 4 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 the adenosine triphosphate, aspartate aminotransferase, and lactate dehydrogenase levels of recipients. Histological examination revealed that graft injury was severe in the pigs with higher hypoxanthine levels. Marked interstitial formation of hypoxanthine in cardiac arrest donors may indicate the degree of warm ischemic injury, indirect evidence of increased free radicals after reperfusion, or a substantial loss of the adenylate pool. These observations suggest that hepatic microdialysate hypoxanthine levels during warm ischemia in the NHBDs were correlated with liver viability before transplantation and that prediction of the viability of the graft may be possible by using this method.
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