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Reduction in nonparenchymal cell injury and vascular endothelial dysfunction after cold preservation of the liver by gaseous oxygen

  • Th. Minor
  • W. Isselhard
  • H. Klauke
Conference paper

Abstract

Reintroduction of oxygen to previously anoxic tissue may result in severe cell injury (oxygen paradox) and contribute to the socalled reperfusion damage of ischemic organs. Our study investigated the influence of simple gaseous oxygen supply during ischemia on nonparenchymal cell alterations upon reperfusion of the liver. Livers from male Wistar rats were isolated, rinsed blood-free and stored for 48 h at 4°C in UW-preservation solution (group 1; n = 6). Gaseous oxygen was insufflated into a second group of livers (group 2; n = 6) during the storage period via the inferior caval vein at a pressure limited to 18 mmHg. To simulate the period of slow rewarming of the organ during surgical implantation in vivo, all livers were incubated at 25°C in saline solution for 30 min prior to reperfusion. Reperfusion was carried out in vitro in a recirculating system with Krebs-Henseleit buffer. A control group was perfused immediately after harvest. The technique of aerobic storage (group 2) resulted in normal vascular perfusion characteristics without elevation of portal venous pressure (PVP) above control values, in contrast to group 1 livers which showed a significantly elevated PVP, averaging between 1.5 and 2 times the values of the control. Hepatic efflux of NO (nmol/ml) after 10 min of reperfusion was massively increased in group 1, while only low concentrations were found in group 2 and in control livers. Kupffer cell activation after ischemia was shown by a huge increase in acid phosphate release upon reperfusion compared with the control, with significantly lower values in group 2 after 10 min of reperfusion than in group 1. Thus, aerobic ischemia by gaseous oxygen persufflation seems an appropriate tool for long-term organ preservation, preventing vascular and parenchymal dysfunction upon reperfusion.

Key words

Persufflation Aerobic ischemia Oxygen Preservation Liver 

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References

  1. 1.
    Arii S, Monden K, Adachi Y, Zhang WH, Higashitsuji H, Furutani M, Mise M, Fujita S, Nakamura T, Imamura M (1994) Pathogenic role of Kupffer cell activation in the reperfusion injury of cold-preserved liver. Transplantation 58: 1072 - 1077PubMedGoogle Scholar
  2. 2.
    Caldwell-Kenkel JC, Currin RT, Tanaka Y, Thurman RG, Lemasters JJ (1991) Kupffer cell activation and endothelial cell damage after storage of rat livers: effects of reperfusion. Hepatology 13: 83 - 95PubMedGoogle Scholar
  3. 3.
    Dunne JB, Davenport M, Williams R, Tredger JM (1994) Evidence that S-adenosylmethionine and N-acetylcysteine reduce injury from sequential cold and warm ischemia in the isolated perfused rat liver. Transplantation 57: 1161 - 1168PubMedCrossRefGoogle Scholar
  4. 4.
    Evans T, Carpenter A, Kinderman H, Cohen J (1993) Evidence of increased nitric oxide production in patients with the sepsis syndrome. Circ Shock 41: 7781Google Scholar
  5. 5.
    Fischer JH, Czerniak A, Hauer U, Isselhard W (1978) A new simple method for optimal storage of ischemically damaged kidneys. Transplantation 25: 43 - 49PubMedCrossRefGoogle Scholar
  6. 6.
    Grace PA (1994) Ischaemia-reperfusion injury. Br J Surg 81: 637 - 647PubMedCrossRefGoogle Scholar
  7. 7.
    Gryglewski RJ, Palmer RMJ, Moncada S (1986) Superoxide anion is involved in the breakdown of endothelium-derived vascular relaxing factor. Nature 320: 454 - 456PubMedCrossRefGoogle Scholar
  8. 8.
    Haba T, Hayashi S, Hachisuka T, Ootsuka S, Tanaka Y, Satou E, Takagi H (1992) Microvascular changes of the liver preserved in UW solution. Cryobiology 29: 310 - 322PubMedCrossRefGoogle Scholar
  9. 9.
    Isselhard W, Berger M, Denecke H, Witte J, Fischer JH, Molzberger H (1972) Metabolism of canine kidneys in anaerobic ischemia and in aerobic ischemia by persufflation with gaseous oxygen. Pflügers Arch 337: 87 - 106PubMedCrossRefGoogle Scholar
  10. 10.
    Isselhard W, Denecke H, Stelter W, Berger M, Sachweh D, Witte J, Fischer JH (1973) Function and metabolism of canine kidneys after aerobic ischemia by orthograde persufflation with gaseous oxygen. Res Exp Med 159: 288297Google Scholar
  11. 11.
    Jin MB, Kobayashi Y, Ochiai T, Yasui J, Ohsada S, Nakano K, Yamagishi H, Hironaka T, Oka T (1994) Relationship between nitric oxide and endothelin-1 during the perioperative phase in canine orthotopic liver transplantation (abstract). Eur Surg Res 26 [Suppl 1]: 27Google Scholar
  12. 12.
    Lillehei RC, Manax WG, Bloch JH, Eyal Z, Hidalgo F, Longerbeam JK (1964) In vitro preservation of whole organs by hypothermia and hyperbaric oxygenation. Cryobiology 1: 182 - 193CrossRefGoogle Scholar
  13. 13.
    Manax WG, Largiader F, Lillehei RC (1966) Whole canine organ preservation. Prolongation in vitro by hypothermia and hyperbaria. JAMA 196: 11211124Google Scholar
  14. 14.
    McKeown CMB, Edwards V, Philips MJ, Harvey PRC, Petrunka CN, Stras-berg SM (1988) Sinusoidal lining cell damage: the critical injury in cold preservation of liver allografts on the rat. Transplantation 46: 178 - 191PubMedCrossRefGoogle Scholar
  15. 15.
    Minor T, Isselhard W (1994) Venous oxygen insufflation to prevent reoxygenation injury after ischemia of a solid organ. Transplantation 58: 121 - 123PubMedGoogle Scholar
  16. 16.
    Minor T, Isselhard W (1996) Synthesis of high energy phosphates during cold ischemic rat liver preservation with gaseous oxygen insufflation. Transplantation 61: 20 - 22PubMedCrossRefGoogle Scholar
  17. 17.
    Minor T, Osswald B, Krauss TW, July N, Isselhard W, Klar E (1995) Determination of plasma activities of purine nucleoside phosphorylase by high performance liquid chromatography: estimates of nonparenchymal cell injury after porcine liver transplantation. J Chromatogr B 670: 332 - 336CrossRefGoogle Scholar
  18. 18.
    Minor Th, Yamaguchi Y, Isselhard W (1995) Effects of taurine on liver preservation in UW solution with consecutive rewarming in the isolated perfused rat liver. Transplant Int 8: 174 - 179CrossRefGoogle Scholar
  19. 19.
    Palmer RMJ, Ferrige AG, Moncada S (1987) Nitric oxide release accounts for the biological activity of endothelium-derived relaxing factor. Nature 327: 524 - 526PubMedCrossRefGoogle Scholar
  20. 20.
    Post S, Palma P, Gonzalez AP, Rentsch M, Menger MD (1994) Timing of arterialization in liver transplantation. Ann Surg 220: 691 - 698PubMedCrossRefGoogle Scholar
  21. 21.
    Rao PN, Walsh TR, Makowka L, Rubin RS, Weber T, Snyder JT, Starzl TE (1990) Purine nucleoside phosphorylase: a new marker for free oxygen radical injury to the endothelial cell. Hepatology 11: 193 - 198PubMedCrossRefGoogle Scholar
  22. 22.
    Rolles K, Foreman J, Pegg D (1989) A pilot clinical study of retrograde oxygen persufflation in renal preservation. Transplantation 48: 339 - 342PubMedCrossRefGoogle Scholar
  23. 23.
    Ross H, Escott ML (1979) Gaseous oxygen perfusion of the renal vessels as an adjunct in kidney preservation. Transplantation 28: 362 - 364PubMedCrossRefGoogle Scholar
  24. 24.
    VanZyl JJW, Groenewald JH, Murphy GP (1970) The influence of hyperbaric oxygen toxicity on renal preservation. Cryobiology 6: 493 - 499CrossRefGoogle Scholar
  25. 25.
    Vaubourdolle M, Chazouilleres O, Poupon R, Ballet F, Braunwald J, Legendre C, Baudin B, Kirn A, Giboudeau J (1993) Creatine kinase-BB: a marker of liver sinusoidal damage in ischemia-reperfusion. Hepatology 17: 423 - 428PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1996

Authors and Affiliations

  • Th. Minor
    • 1
  • W. Isselhard
    • 1
  • H. Klauke
    • 1
  1. 1.Institute for Experimental MedicineUniversity of CologneCologneGermany

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