Analysis of the liver effluent as a marker of preservation injury and early graft performance.

In liver transplantation, the effluent solution, which represents the washout of residual preservation solution, can be collected before reperfusion to determine the release of the markers of endothelial cell injury and damage to the liver. The enzyme activities detected in the washout solution may allow the development of an index that could be clinically valuable for the prediction of early posttransplant graft function. In the present study, we collected liver effluents from 47 livers at the time of graft rinsing to measure liver enzymes (aminotransferases and lactate dehydrogenase) as well as the serum enzyme levels of the recipients for correlation with early postoperative graft viability (1-month survival). The patients were divided into two groups: death (D) and survival (S). Nonparametric statistical analysis was used with the level of significance set at P < .05. Aminotransferases and lactate dehydrogenase levels higher among the D group (P < .05 for all measurements), leading us to conclude that the effluent represents a good marker of preservation injury and early graft performance.

Liver transplantation at a university hospital, faculty of the medicine of Ribeirão Preto, University of São Paulo: results for the first 60 recipients.

The purpose of the present article was to present the series operated by a Liver Transplant Group of the interior of the State of Sao Paulo, Brazil. Sixty patients were transplanted from May 2001 to May 2007. Thirty percent of the patients had alcoholic cirrhosis. 18.3% had C virus-induced cirrhosis, 10% had C virus- and alcohol-induced cirrhosis, 6% had B virus-induced cirrhosis, 13.3% had cryptogenic cirrhosis, 8.3% autoimmune cirrhosis, 13.3% had familial amyloidotic polyneuropathy (FAP), and 13.3% had hepatocellular carcinomas. The series was divided by a chronological criterion into two periods: A (n = 42) and B (n = 18) with the latter group operated based upon the Model for End-stage Liver Disease (MELD) criterion. Sixty-nine percent were men. Age ranged from 14 to 66 years. Period A included 12% Child A: 59.2%, Child B; 24%, Child C; and 4.8%, FAP. Period B comprises 22.2% Child A: 11.1%, Child B: 33.3%, Child C: and 33.3%, FAP. MELD scores ranged from 8 to 35 for period A and from 14 to 31 for period B. Intraoperative mortality was 2/42 patients for period A and 0/18 for period B, overall postoperative mortality was 40% including for period A, 35% among Child B and C patients, and 5% among FAP and Child A patients (P < .05) and 16.6% for period B among 11.1% Child B patients and 5.5% FAP patients; 3.3% of patients required retransplantation due to hepatic artery thrombosis. Real postoperative survival was 60% during period A and 83.3% during period B, with an overall survival rate of 67% for the two periods. The present results show levels of postoperative mortality, (especially during period B), and survival rates similar to those reported by several other centers in Brazil.

Efeitos do pré-condicionamento hepático em ratos cirróticos, submetidos à isquemia e reperfusão hepática resultados preliminares

We studied the influence of ischemic preconditioning in rat liver cirrhosis.The cirrhosis were induced in wistar rat with occlusion of biliary duct before 30 days operation and divided into group A, ischemic preconditioning and ischemic/reperfusion, and group B, only ischemic/reperfusion. In group A the preconditioning consisted of 5 min ischemic and 10 min reperfusion. The ischemic/reperfusion consisted of 20 min ischemic and 120 min reperfusion for both groups. The level of respiratory control reason (RCR) in the liver tissue 120 min after reperfusion was not difference significantly in the groups. Therefore it suggests that the preconditioning cam be viability and another object of studies must be rated in future this work.

Baseando-se nos efeitos estimuladores do metabolismo energético pelo pré-condicionamento isquêmico (PCI) no tecido hepático, estudou-se dois grupos de ratos cirróticos submetidos a isquemia de 20 min e reperfusão de 120 min, após o PCI ou não respectivamente, determinando assim o valor do seu uso no prolongamento da manobra de Pringle e na regeneração hepática na hepatectomia.

Efeitos do pré-condicionamento hepático em ratos cirróticos, submetidos à isquemia e reperfusäo hepática: resultados preliminares / Effects of the hepatic preconditioning in rats with liver cirrhosis, submitted to ischemia of the hepatic reperfusion: preliminary result

Baseando-se nos efeitos estimuladores do metabolismo energético pelo pré-condicionamento isquêmico (PCI) no tecido hepático, estudou-se dois grupos de ratos cirróticos submetidos a isquemia de 20 min e reperfusäo de 120 min, após o PCI ou näo respectivamente, determinando assim o valor do seu uso no prolongamento da manobra de Pringle e na regeneraçäo hepática na hepatectomia. Descritores: Cirrose hepática; isquemia hepática; razäo de controle respiratório(RCR); pré-condicionamento isquêmico hepático.

Avaliaçäo da funçäo mitochondrial do fígado submetido a isquemia parcial com e sem pré-condicionamento isquêmico / Evaluation of liver mitochondrial function submitted to partial ischemia with and without ischemic preconditioning

Estudou-se o papel do pré-condicionamento isquêmico de 5 minutos sobre o efeito da isquemia hepática de 2 horas seguida de reperfusäo de 1 hora. Verificou-se a Razäo de Controle Respiratório (RCR) foi significativamente maior nos animais submetidos à isquemia hepático com pré-condicionamento prévio de 5 minutos.

Aspecto funcional do remanescente hepático em condiçöes de isquemia e reperfusäo após hepatectomia parcial / Functional aspects of hepatic remmanescent in ischemia and reperfusion condiction after parcial hepatectomy

O efeito da hipotermia, precondicionamento isquêmico e drogas protetoras das lesöes de isquemia e reperfusäo têm sido amplamente estudado. O objetivo do presente estudo é avaliar os efeitos da deferoxamina na isquemia e reperfusäo sobre o fígado remanescente após ressecçäo hepática parcial a 70 por cento, avaliando-se a funçäo mitocondrial hepática. Estudou-se 34 ratos divididos em grupos: Grupo HP (n = 8) - submetidos a hepatectomia parcial (HP) a 70 por cento; Grupo HPD (n = 4) - submetidos a administraçäo de deferoxamina (40 mg/kg) e HP a 70 por cento; Grupo HPI (n = 7) - hepatectomizados (HP a 70 por cento) e submetidos a isquemia (40 minutos); Grupo HPID (n = 7) - semelhante ao anterior, porém recebendo previamente deferoxamina; Grupo C (n = 8) - controle, submetido a operaçäo simulada para HP a 70 por cento. A análise estatística entre os diversos grupos foi feita pelos testes de Kruskal - Wallis e de Mann - Whitney, com nível de significância de 5 por cento. Dessa maneira, o estado III foi semelhante em todos os procedimentos; o estado IV: C