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- W1978199625 abstract "416 Energy metabolism has been related to the extend of ischemic tissue damage in human and experimental models. The use of normothermic recirculation (NR) by means of cardiopulmonary bypass (CPB) has shown a beneficial effect on energy charge (EC) in liver procurement from NHBD. Aim: To study the effect of cardiopulmonary resuscitation (CPR) on adenine nucleotides concentrations and histological changes in liver biopsies from NHBD. MM: : 20 pigs were transplanted (Ltx) with an allograft from NHBD with the following characteristics: jugular vein, aorta and cava were cannulated and connected to a blood oxygenator, a heat exchanger and a non-pulsatil roller pump. Cardiac arrest (CA) was produced by directly inducing ventricular fibrillation. Three groups were designed: G0 Control group (30′ CA), G1 (10′ CA+20′ CPR), G2 (10′ CA+ 20′ CPR+ 0.02 mg/Kg epinephrine + 0.015 mg/Kg). NR was started and maintained during another 30′ at the maximum flow rate. Then, TBC was initiated until liver temperature reached 15°C. Liver procurement was completed and Ltx performed after six hours of cold ischemia. Tissue samples were taken at the beginning after the period of warm ischemia (WI) and NR in the donor, and before (IF) and one hour after reperfusion (RP) in the recipient for light microscopy evaluation. Adenine nucleotides and metabolite levels were also measured by HPLC. Results. Adenine nucleotide levels and EC decreased during WIT and the Control group presented the lowest levels. ADP was significantly lower in G0 vs G2 (p=0.035). Furthermore, Hypoxantine was significantly higher in Go when compared to G1 and G2 (p<0.04). These results correlated with histological changes: severity of lesions was higher in the control group for sinusoidal inflammation (p<0.0001), dilatation (p<0.012), congestion (p<0.024) and hepatocyte vacuolization (p<0.023) during liver procurement and Ltx. Conclusions: CPR in NHBD is capable to avoid to a certain extent the loss in EC produced after the period of WI and is responsible for lower degree of histological damage. Although better results were obtained in CPR group with drugs, we have not been able to show a significant beneficial effect of vasoactive drugs on ischemic liver injury." @default.
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- W1978199625 date "1999-05-01" @default.
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- W1978199625 title "CHANGES IN ADENINE NUCLEOTIDES AND THEIR METABOLITES IN LIVER TISSUE CONCENTRATION FROM TYPE II NON HEART BEATING DONOR (NHBD) PIGS." @default.
- W1978199625 doi "https://doi.org/10.1097/00007890-199905150-00439" @default.
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