Net M, Valero R, Almenara R, Rull R, Gonzalez F J, Taurá P, Lopez-Boado M A, Deulofeu R, Elena M, Capdevila L, Cabrer C, Visa J, García-Valdecasas J C
Department of Anesthesiology, Biochemistry and Transplant Coordination of the Hospital Clínic de Barcelona, Universitat de Barcelona, Spain.
Transplantation. 2001 May 15;71(9):1232-7. doi: 10.1097/00007890-200105150-00009.
The aim of the present study was to evaluate hepatic content of adenine nucleotides and their degradation products in non-heart-beating donor (NHBD) pigs and its relationship with recipient survival.
Thirty animals were transplanted with an allograft from NHBDs. After warm ischemia (WI) time (20, 30, or 40 min), cardiopulmonary bypass and normothermic recirculation (NR) were run for 30 min. Afterward, the animals were cooled to 15 degrees C and liver procurement was performed.
Survival rate was 100% in the 20WI, 70% in the 30WI, and 50% in the 40WI. Livers from non-surviving animals had higher levels of xanthine after NR than livers from surviving animals. Logistic regression analysis revealed that xanthine at the end of NR was the only variable able to predict survival with a calculated sensitivity of 80% and a specificity of 60%. Prolongation of warm ischemic period leaded to a greater xanthine accumulation as well as increased plasma alpha-glutathione S-transferase levels at reperfusion. Xanthine at NR and alpha-glutathione S-transferase at reperfusion significantly correlated, indicating that donor xanthine contributes to some extent to the severity of the lesion by ischemia-reperfusion.
It is suggested that xanthine content in the donor is able to predict survival after transplantation. Xanthine is significantly involved in the hepatic lesion elicited by warm ischemia and subsequent ischemia-reperfusion associated to liver transplantation from a NHBD.
本研究旨在评估非心脏跳动供体（NHBD）猪肝脏中腺嘌呤核苷酸及其降解产物的含量及其与受体存活的关系。
30只动物接受了来自NHBD的同种异体移植。在热缺血（WI）时间（20、30或40分钟）后，进行体外循环和常温再灌注（NR）30分钟。之后，将动物冷却至15摄氏度并进行肝脏获取。
20分钟热缺血组的存活率为100%，30分钟热缺血组为70%，40分钟热缺血组为50%。未存活动物的肝脏在再灌注后黄嘌呤水平高于存活动物的肝脏。逻辑回归分析显示，再灌注结束时的黄嘌呤是唯一能够预测存活的变量，计算得出的敏感性为80%，特异性为60%。热缺血期的延长导致黄嘌呤积累增加以及再灌注时血浆α-谷胱甘肽S-转移酶水平升高。再灌注时的黄嘌呤与再灌注时的α-谷胱甘肽S-转移酶显著相关，表明供体黄嘌呤在一定程度上导致了缺血再灌注损伤的严重程度。
提示供体中的黄嘌呤含量能够预测移植后的存活情况。黄嘌呤显著参与了由热缺血以及随后与NHBD肝脏移植相关的缺血再灌注引起的肝脏损伤。
