scholarly journals Recipient Hyperbilirubinemia May Reduce Ischemia-Reperfusion Injury but Fails to Improve Outcome in Clinical Liver Transplantation

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Mihai Oltean ◽  
Christian Barrenäs ◽  
Paulo Ney Martins ◽  
Gustaf Herlenius ◽  
Bengt Gustafsson ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Reperfusion Injury ◽  
Ischemia Reperfusion Injury ◽  
Ischemia Reperfusion ◽  
Risk Index ◽  
Graft Loss ◽  
Antioxidant Properties ◽  
First Year ◽  
Early Graft ◽  
High Bilirubin

Background.Exogenous bilirubin may reduce experimental ischemia-reperfusion injury (IRI) due to its antioxidant properties. We studied if early graft exposure to high bilirubin levels in the recipient affects the early IRI and outcomes after liver transplantation (LTx).Methods.In 427 LTx patients, the AUROC curve based on bilirubin and AST at day 1 identified a cutoff of 2.04 mg/dL for the recipient pretransplant bilirubin. Recipients were grouped as having low (group L,n=152) or high (group H,n=275) bilirubin. Both groups had similar donor-related variables (age, preservation time, donor BMI > 28, and donor risk index (DRI)).Results.Alanine (ALT) and aspartate (AST) aminotransferase levels were higher in group L at day 1; ALT levels remained higher at day 2 in group L. LTx from high risk donors (DRI > 2) revealed a trend towards lower transaminases during the first two days after transplantation in group H. One month and 1-year patient survival were similar in groups L and H. High preoperative bilirubin did not affect the risk for early graft dysfunction (EGD), death, or graft loss during the first year after transplantation nor the incidence of acute rejection. LTx using donors with DRI > 2 resulted in similar rates of EGD in both groups.Conclusion.Increased bilirubin appears to reduce the early IRI after LTx yet this improvement was insufficient to improve the clinical outcome.

Protocol for the pig liver ischemia/reperfusion injury

2020 ◽  
Author(s):  
Eric Felli ◽  
Mahdi Al-Taher ◽  
Emanuele Felli ◽  
Lorenzo Cinelli ◽  
Michele Diana
Keyword(s):  
Liver Transplantation ◽  
Reperfusion Injury ◽  
Liver Damage ◽  
Porcine Model ◽  
Ischemia Reperfusion Injury ◽  
Ischemia Reperfusion ◽  
Graft Loss ◽  
Vascular Complication ◽  
Liver Ischemia ◽  
Pig Liver

Abstract Liver ischemia/reperfusion injury (IRI) is a dreadful vascular complication, which leads to liver damage. It is often associated with graft loss in liver transplantation and with a higher morbidity and mortality. IRI can have different causes, such as inflow clumping during surgical procedures in hepatic resection, liver transplantation, trauma, as well as during the stenosis of the vasculature caused by cancer. Here, we show a detailed IRI protocol in a porcine model.

scholarly journals Ischemic Preconditioning for Liver Transplantation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2021 ◽  
pp. 1-8
Author(s):  
Lina Jakubauskiene ◽  
Matas Jakubauskas ◽  
Philipp Stiegler ◽  
Bettina Leber ◽  
Peter Schemmer ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Mortality Rate ◽  
Randomized Controlled Trials ◽  
Ischemic Preconditioning ◽  
Ischemia Reperfusion Injury ◽  
Ischemia Reperfusion ◽  
Meta Analysis ◽  
Graft Loss ◽  
Controlled Trials ◽  
Randomized Controlled

<b><i>Background:</i></b> In recent decades, liver transplantation (LTx) has increased the survival and quality of life of patients with end-stage organ failure. Unfortunately, LTx is limited due to the shortage of donors. A lot of effort is put into finding new ways to reduce ischemia-reperfusion injury (IRI) in liver grafts to increase the number of suitable organs procured from expanded-criteria donors (ECD). The aim of this study was to systematically review the literature reporting LTx outcomes when using ischemic preconditioning (IPC) or remote ischemic preconditioning (RIPC) to reduce IRI in liver grafts. <b><i>Methods:</i></b> A literature search was performed in the MEDLINE, Web of Science, and EMBASE databases. The following combination was used: “Liver” OR “Liver Transplantation” AND “Ischemic preconditioning” OR “occlusion” OR “clamping” OR “Pringle.” The following outcome data were retrieved: the rates of graft primary nonfunction (PNF), retransplantation, graft loss, and mortality; stay in hospital and the intensive care unit; and postoperative serum liver damage parameters. <b><i>Results:</i></b> The initial search retrieved 4,522 potentially relevant studies. After evaluating 17 full-text articles, a total of 9 randomized controlled trials (RCTs) were included (7 IPC and 2 RIPC studies) in the qualitative synthesis; the meta-analysis was only performed on the data from the IPC studies. RIPC studies had considerable methodological differences. The meta-analysis revealed the beneficial effect of IPC when comparing postoperative aspartate aminotransferase (AST) corresponding to a statistically lower mortality rate in the IPC group (odds ratio [OR] 0.51; 95% confidence interval [CI] 0.27–0.98; <i>p</i> = 0.04). <b><i>Conclusion:</i></b> IPC lowers postoperative AST levels and reduces the mortality rate; however, data on the benefits of RIPC are lacking.

scholarly journals Impact of Three Methods of Ischemic Preconditioning on Ischemia-Reperfusion Injury in a Pig Model of Liver Transplantation

2021 ◽  
pp. 1-10
Author(s):  
Alessandro Rodrigo Belon ◽  
Ana Cristina Aoun Tannuri ◽  
Daniel de Albuquerque Rangel Moreira ◽  
Jose Luiz Figueiredo ◽  
Alessandra Matheus da Silva ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Reperfusion Injury ◽  
Ischemic Preconditioning ◽  
Ischemia Reperfusion Injury ◽  
Ischemia Reperfusion ◽  
Pig Model

scholarly journals Early cytokine signatures of ischemia/reperfusion injury in human orthotopic liver transplantation

JCI Insight ◽  
2016 ◽  
Vol 1 (20) ◽  
Author(s):  
Rebecca A. Sosa ◽  
Ali Zarrinpar ◽  
Maura Rossetti ◽  
Charles R. Lassman ◽  
Bita V. Naini ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Reperfusion Injury ◽  
Orthotopic Liver Transplantation ◽  
Ischemia Reperfusion Injury ◽  
Ischemia Reperfusion

scholarly journals Thymoglobulin and ischemia reperfusion injury in kidney and liver transplantation

2007 ◽  
Vol 22 (Supplement 8) ◽  
pp. viii54-viii60 ◽  
Author(s):  
A. Mehrabi ◽  
Zh. A. Mood ◽  
M. Sadeghi ◽  
B. M. Schmied ◽  
S. A. Muller ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Reperfusion Injury ◽  
Ischemia Reperfusion Injury ◽  
Ischemia Reperfusion

Ischemia-Reperfusion Injury in Liver Transplantation

2015 ◽  
pp. 1438-1451
Author(s):  
Jerzy W. Kupiec-Weglinski ◽  
Yuan Zhai ◽  
Ana J. Coito ◽  
Henrik Petrowsky ◽  
Johnny C. Hong ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Reperfusion Injury ◽  
Ischemia Reperfusion Injury ◽  
Ischemia Reperfusion

scholarly journals Therapeutic Potential of Selenium as a Component of Preservation Solutions for Kidney Transplantation

Molecules ◽  
2020 ◽  
Vol 25 (16) ◽  
pp. 3592
Author(s):  
Aneta Ostróżka-Cieślik ◽  
Barbara Dolińska ◽  
Florian Ryszka
Keyword(s):  
Reperfusion Injury ◽  
Activity Concentration ◽  
Ischemia Reperfusion Injury ◽  
Therapeutic Potential ◽  
Ischemia Reperfusion ◽  
Antioxidant Properties ◽  
Preservation Solution ◽  
Kidney Preservation ◽  
Preservation Solutions ◽  
Metabolic Reduction

Selenium has strong antioxidant properties and diverse effects on the immune system. The aim of the study was to analyse the protective effect of selenium as a component of a kidney preservation solution on the prevention of ischemia-reperfusion injury of nephrons. The solution was modified by the addition of Se (1 µg/L), prolactin (0.1 µg/L) and Se with prolactin (1 µg/L Se + 0.1 µg/L PRL). The study used a model for storing isolated porcine kidneys in Biolasol® (modified Biolasol®), which minimizes ischemia-reperfusion injury of grafts. The introduction of Se4+ ions at a dose of 1 µg/L into the Biolasol® preservation solution in the form of Na2SeO3 caused an increase in the activity/concentration of the analysed biochemical parameters: aspartate transaminase, alanine transaminase, urea and protein. This suggests an adverse effect of Se4+ on nephron function during ischemia-reperfusion. The best graft protection was obtained by using Biolasol® modified with the addition of selenium (IV) at a dose of 1 µg/L and prolactin at a concentration of 0.1 µg/L. We proposed the mechanism of prolactin action in the metabolic reduction of selenite (SO32−) during ischemia/reperfusion.

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