Impact of 6% Starch 130/0.4 and 4% Gelatin Infusion on Kidney Function in Living-Donor Liver Transplantation.

BACKGROUND: Since the first liver transplantation, pretransplantation or post-transplantation renal problems are still among the main causes of mortality and morbidity. The aim of this study was to evaluate the effects of fluid replacement solutions used intraoperatively on renal functions in elective living-donor liver transplantation. METHODS: After Ethics Committee approval, informed consents were obtained from patients. Patients with normal renal functions and scheduled for elective living-donor-liver transplantation were included in the study. Patients were randomly allocated to infusion with 6% hydroxyehylstarch 130/40 (HES group) and 4% Gelofusine (GEL group). Blood samples were obtained before the induction of anesthesia (baseline), at the end of the operation, and postoperative days 1 and 4. Different estimated glomerular filtration rate (eGFR) formulas using creatinine (modification of renal disease, chronic kidney disease-epidemiology collaboration and Cockraud Gault) were used to calculate the eGFR. RESULTS: Thirty-six patients were included in the study (GEL group = 18; HES group = 18). Patient characteristics, modified end stage liver disease-Child Pugh score, American Society of anaesthesiologist scores, and intraoperative data were similar between groups. Postoperative measurements showed that creatinine was significantly higher in the GEL group compared with the baseline, which was not the case for the HES group. Similarly, postoperative eGFR levels, as measured using MDRD and CKD-EPI, were found to be significantly lower in the GEL group. Postoperative urine albumin:creatinine ratios were significantly higher in the GEL group compared with baseline. Total crystalloid amount used, colloid, blood, fresh frozen plasma values, extubation, and intensive care unit (ICU) and hospital stay were similar in both groups. Postreperfusion syndrome developed in 6 patients in each group. CONCLUSION: In conclusion, Gelofusine seem to cause more impairment in renal functions in elective living-donor liver transplantation.

Inhibitory actions of hydroxocobalamin, cyanocobalamin, and folic acid on the ultraviolet light-induced relaxation of the frog upper oesophageal strip.

The applications of ultraviolet (UV) light (336 nm) on the upper oesophageal strips of frog elicited relaxant responses in the presence of NaNO2 (50 microM). The tissues were mounted under the tension 0.5 g in an organ bath containing Ringer solution, maintained at 25 degrees C and gassed with 100% O2. The responses were recorded on a kymograph via an isotonic lever. Antimegaloblastic agents, including hydroxocobalamin (1, 10, and 100 microM), cyanocobalamin (1, 10, 25, and 100 microM), and folic acid (1, 10, 50, 100, and 200 microM), significantly attenuated the relaxation response to UV light. Folinic acid (1, 10, 25, and 100 microM), however, enhanced the relaxation. Pyrogallol (50 microM), hydroquinone (50 microM), and diethyldithiocarbamic acid (8 mM) were found ineffective for attenuation, though FeSO4 (200, 400, and 500 microM) and hemoglobin (50 microM), respectively, exerted significant inhibition. L-arginine methylester (500 microM) did not impair UV-induced relaxation. Based on these results, we concluded that a mechanism involving undefined action(s) of antimegaloblastic drugs may cause alterations in the UV light-induced relaxation of the tissue used.

Restorative effects of zinc and selenium on nitrergic relaxations impaired by cadmium in the mouse corpus cavernosum.

We investigated whether Cd2+ intake (in drinking water, 15 ppm) for 30 days can affect the nitrergic relaxations of the mouse corpus cavernosum (CC) and whether Zn2+ (25 mg kg(-1) via a stomach tube at 48-h intervals) or sodium selenate (8 microg kg(-1) day(-1) intraperitoneally) has a restorative action on the impairment in the response. Relaxant responses of the CC obtained from Cd2+-treated mice to electrical field stimulation (neurogenic) or acetylcholine (endothelium dependent) were significantly inhibited. A partial restoration was observed in the nitrergic relaxation of the CC obtained from Zn2+- or sodium selenate-co-treated animals. Neither agent exhibited any significant action on the responses of the tissue from control mice. There was no significant difference between Cd2+-treated and control mice in respect of the relaxation amplitude induced by sodium nitroprusside or papaverine. These results suggest that Cd2+ intake may impair the nitrergic relaxation of the mouse CC, and, co-treatment with Zn2+ or sodium selenate may partially improve the nitrergic mechanisms in the tissue.

A possible role of S-nitrosothiols at the nitrergic relaxations in the mouse corpus cavernosum.

Relaxations induced by electrical field stimulation and acetylcholine were compared with those induced by acidified sodium nitrite, sodium nitroprusside, S-nitrosoglutathione and S-nitroso-N-acetyl-D,L-penicillamine in the mouse corpus cavernosum precontracted with phenylephrine. NG-nitro-L-arginine inhibited electrical field stimulation- or acetylcholine-induced relaxation, but was ineffective on relaxations caused by the other stimuli. Hydroquinone and pyrogallol had no inhibitory action on the relaxations caused by any stimulus except acidified sodium nitrite. Incubation of the tissue with diethyldithiocarbamic acid significantly inhibited the relaxations induced by all stimuli except papaverine. In the tissues pre-treated with diethyldithiocarbamic acid, superoxide dismutase, hydroquinone and pyrogallol failed to yield restore or further inhibit the relaxations in response to electrical field stimulation or acetylcholine. LY 83583 (6-anilino-5,8-quinolinedione) and hydroxocobalamin clearly inhibited the relaxant responses to electrical field stimulation, acetylcholine, S-nitrosoglutathione and acidified sodium nitrite whereas there was significant enhancement of the relaxation produced by S-nitroso-N-acetyl-D,L-penicillamine. These findings suggest that the relaxant factor released from non-adrenergic non-cholinergic nerves or endothelial cells in mouse cavernosal tissue may be a superoxide anion-resistant nitric oxide-containing molecule and that S-nitrosoglutathione rather than S-nitroso-N-acetyl-D,L-penicillamine could be a suitable candidate for this.

The effect of Ba2+ on the nitrergic mechanism in the isolated frog lung preparation.

1. The present study was undertaken to investigate effects of Ba2+ on the isolated frog lung strips depolarized by 20 mM K+ in Ca2+ free Ringer solution. 2. Ba2+ produced monophasic relaxant response, whereas Ca2+ induced biphasic response consisting of a transient relaxation and a marked contraction. Both kinds of relaxation were inhibited completely by L-NOARG. L-arginine reversed the action of L-NOARG. 3. Ferrous sulfate, pyrogallol, hydroquinone, and vanadate reduced the Ba(2+)-induced relaxation in a concentration-dependent manner. 4. These findings suggest that Ba(+)-induced relaxation may fully be mediated by the nitrergic mechanism and the effect of Ba2+ on the nitric oxide synthase may be more selective than Ca2+.

An in vitro study of nonadrenergic-noncholinergic activity on the cavernous tissue of mouse.

The relaxant effects of electrical field stimulation (EFS) and exogenously applied acetylcholine (ACh) or acidified NaNO2 (a-NaNO2) were investigated in the isolated mouse corpus cavernosum precontracted with phenylephrine hydrochloride (PE). Tetrodotoxin (TTX) blocked the relaxant effects of EFS completely, whereas it had no effect on the responses to ACh or a-NaNO2. Guanethidine and indomethacin failed to affect the electrically or ACh-induced relaxations. Atropine completely blocked the effect of ACh; however, it caused a slight reduction in the relaxation evoked by EFS. NG-Nitro-L-arginine (L-NOARG) reduced the effects of EFS and ACh significantly, but it was ineffective on the relaxations induced by a-NaNO2. The inhibitory action of L-NOARG was partly restored by L-arginine, but not by D-arginine. Methylene blue (MB) and hydroxocobalamin (HC) exhibited significant inhibition on the relaxations evoked by EFS, ACh and a-NaNO2. Hydroquinone (HQ) reduced relaxation due to a-NaNO2, but did not affect that of EFS and ACh. Our findings suggest that EFS-induced relaxations of mouse cavernosal tissue are mediated by a transmitter which probably resembles an organic nitrate.