Jawan Bruno, Goto Shigeru, Lai Chia-Yun, de Villa Vanessa H, Luk Hsiang-Ning, Eng Hock-Liew, Chen Yaw-Sen, Wang Chi-Chih, Cheng Yu-Fen, Chen Chao-Long
Department of Anesthesiology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University, 123 Ta-Pei Road, Niao-Sung, Kaohsiung 83305, Taiwan.
Anesth Analg. 2002 Nov;95(5):1169-72, table of contents. doi: 10.1097/00000539-200211000-00007.
Hypernatremia in the donor organ is one of the most dangerous risk factors that may cause primary graft loss after orthotopic liver transplantation (OLT). However, the viability of donor grafts from acute hypernatremic donors, which is likely to occur during resuscitation of trauma patients with hypertonic saline solution, has not been studied precisely. In the present study, we sought to evaluate whether the hypernatremia, per se, induced by hypertonic saline solution, affects the outcome of liver transplantation in the normal rat. Thirty minutes after the induction of hypernatremia (>160 mEq/L), the livers of nine Wistar rats were removed under ether anesthesia. Six livers were immediately transplanted into normal Wistar rats, whereas the other three were preserved in 4 degrees C University of Wisconsin solution for 6 h before transplantation in the recipients. Liver function variables of the donor rats at graft procurement and of the recipients at Day 7 after OLT were compared with a control group. The water content of the graft at procurement and the survival of the recipients at 7 days after OLT were, likewise, compared with the untreated control group. Results showed that there were no significant differences in the liver function tests of the donors and recipients, as well as in the water content of the grafts, between groups. All the rats survived the observation period of 7 days. This study showed that acute hypernatremia induced by the infusion of 10% saline solution before graft procurement in a nonbrain-dead donor rat model did not lead to a deterioration of liver graft viability after OLT.
Hypernatremia in cadaveric donors may be detrimental to the graft in clinical liver transplantation, but acute donor hypernatremia induced by an IV infusion of 10% saline solution before graft procurement in nonbrain-dead rats did not affect the survival of the recipient rats in an experimental liver transplantation model.
