Xu Min, Alwahsh Salamah M, Kim Myung-Ho, Kollmar Otto
Department of General, Visceral, and Pediatric Surgery, University Medical Center Göttingen, Göttingen, Germany.
Liver Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.
Transpl Int. 2024 Dec 13;37:13557. doi: 10.3389/ti.2024.13557. eCollection 2024.
The scarcity of donors has prompted the growing utilization of steatotic livers, which are susceptible to injuries following orthotopic liver transplantation (OLT). This study aims to assess the efficacy of multidrug donor preconditioning (MDDP) in alleviating injuries of steatotic grafts following rat OLT. Lean rats were subjected to a Western-style diet with high-fat (HF) and high-fructose (HFr) for 30 days to induce steatosis. Both lean and steatotic livers were implanted into lean recipients fed with a chow diet after OLT. The HF + HFr diet effectively elevated blood triglyceride and cholesterol levels and induced fat accumulation in rat livers. Our results demonstrated a significant decrease in alanine aminotransferase levels ( = 0.003), aspartate aminotransferase levels ( = 0.021), and hepatic Suzuki scores ( = 0.045) in the steatotic rat liver allograft group following MDDP treatment on post-operation day (POD) 7. Furthermore, the survival rates of steatotic rat liver allografts with MDDP (19/21, 90.5%) were significantly higher than those in the steatotic control (12/21, 57.1%, * = 0.019). These findings indicate that MDDP treatment improves steatotic rat liver allograft function and recipient survival following OLT.
供体的稀缺促使脂肪变性肝脏的利用率不断提高，而脂肪变性肝脏在原位肝移植（OLT）后易受损伤。本研究旨在评估多药供体预处理（MDDP）对减轻大鼠OLT后脂肪变性移植物损伤的疗效。将健康大鼠给予高脂（HF）和高果糖（HFr）的西式饮食30天以诱导脂肪变性。OLT后，将健康肝脏和脂肪变性肝脏均植入喂食普通饲料的健康受体。HF + HFr饮食有效地提高了大鼠血液中的甘油三酯和胆固醇水平，并诱导了肝脏脂肪堆积。我们的结果表明，在术后第7天（POD 7）进行MDDP治疗后，脂肪变性大鼠肝移植组的丙氨酸转氨酶水平（ = 0.003）、天冬氨酸转氨酶水平（ = 0.021）和肝脏铃木评分（ = 0.045）均显著降低。此外，接受MDDP治疗的脂肪变性大鼠肝移植的存活率（19/21，90.5%）显著高于脂肪变性对照组（12/21，57.1%，* = 0.019）。这些发现表明，MDDP治疗可改善大鼠OLT后脂肪变性肝移植的功能和受体存活率。
