Lin N-C, Liu C-S, Chang C-J, Loong C-C, Hsia C-Y, Tsai H-L
Division of Transplantation Surgery, Department of Surgery, Taipei Veterans General Hospital, National Yang-Ming University School of Medicine, Taipei, Taiwan.
Transplant Proc. 2010 Apr;42(3):721-4. doi: 10.1016/j.transproceed.2010.03.008.
Ischemia-reperfusion (I-R) injury plays an important role in the immediate graft function in living-donor liver transplantation (LDLT). There is growing evidence that mitochondria play a pivotal role in I-R injury. Our aim was to evaluate changes in mitochondrial respiratory enzyme activities after I-R injury in LDLT.
Specimens from 8 donor recipient pairs enrolled in this study were obtained from the donor livers before harvest (before I-R injury) and after vascular anastomosis in the recipient (after I-R injury). Histidine-tryptophan-ketoglutarate solution was used to perfuse the organ during the cold ischemic period between harvesting and transplantation. We correlated changes in mitochondrial respiratory enzyme complex activity (succinate cytochrome c reductase [SCCR]; NADH cytochrome c reductase [NCCR]) after I-R injury with clinical data and graft status.
NCCR and SCCR activities did not uniformly decrease after I-R injury. Two of 8 recipients experienced graft dysfunction after transplantation. The decrease in neither NCCR nor SCCR activity correlated with graft dysfunction in these 2 patients. Among the clinical factors, grafts from older donors tended to show decreased NCCR activity after I-R injury.
In this study, changes in mitochondrial respiratory enzyme activity failed to predict the severity of I-R injury in LDLT. The organ preservation solution may play a protective role on mitochondrial respiratory enzymes during I-R injury.
缺血再灌注(I-R)损伤在活体肝移植(LDLT)的即刻移植物功能中起重要作用。越来越多的证据表明线粒体在I-R损伤中起关键作用。我们的目的是评估LDLT中I-R损伤后线粒体呼吸酶活性的变化。
本研究纳入的8对供受体的标本,取自供肝获取前(I-R损伤前)以及受体血管吻合后(I-R损伤后)。在获取与移植之间的冷缺血期,使用组氨酸-色氨酸-酮戊二酸溶液灌注器官。我们将I-R损伤后线粒体呼吸酶复合物活性(琥珀酸细胞色素c还原酶[SCCR];NADH细胞色素c还原酶[NCCR])的变化与临床数据及移植物状态相关联。
I-R损伤后NCCR和SCCR活性并非一致降低。8例受体中有2例在移植后出现移植物功能障碍。这2例患者中,NCCR和SCCR活性的降低均与移植物功能障碍无关。在临床因素中,来自年长供体的移植物在I-R损伤后往往显示NCCR活性降低。
在本研究中,线粒体呼吸酶活性的变化未能预测LDLT中I-R损伤的严重程度。器官保存液可能在I-R损伤期间对线粒体呼吸酶起保护作用。