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Liver Graft Function (liver + graft_function)
Selected AbstractsEffect of apoE/ATP-containing liposomes on hepatic energy stateLIVER INTERNATIONAL, Issue 5 2003S. Chaďb Abstract: Background/Aims: ATP-containing liposomes partially prevent ATP depletion in the cold-stored liver. As hepatocytes can specifically bind apoE, we investigated whether the addition of apoE to large (200 nm) ATP-containing liposomes increases their uptake by the liver and further improves hepatic energy stores. Methods: Livers from fasted male Hartley guinea-pigs (231±3 g) were perfused for 90 min under our standard conditions (Control, n=6) or after a single bolus addition of plain liposomes (Lip, n=6), ATP (5 ,mol)-containing liposomes (ATP-Lip, n=6) or apoE/ATP-containing liposomes (0.8 or 8 mg apoE/g phospholipids; apoE1-Lip and apoE10-Lip, respectively, n=6 in each group). Liposome uptake and its impact on energy and nitrogen metabolism were studied. Results: At its highest concentration, apoE significantly increased liposome uptake (apoE10-Lip:,9.17±0.69 vs apoE1-Lip:,6.18±0.44 vs ATP-Lip:,6.40±0.88 nmol min,1 g,1; P<0.05). This was associated with a significant increase in intrahepatic ATP (apoE10-Lip: 1033±137 vs apoE1-Lip: 811±98 and ATP-Lip: 648±36 nmol g,1; P<0.05), which was restored to its level in non-perfused livers. Hepatic viability and nitrogen metabolism were not affected. Conclusions: Hepatic ATP content being a key factor in the maintenance of liver graft function, apoE/ATP-containing liposomes should be useful in liver preservation for transplantation. [source] Mycophenolate Mofetil Monotherapy for Severe Side Effects of Calcineurin Inhibitors Following Liver TransplantationAMERICAN JOURNAL OF TRANSPLANTATION, Issue 3 2009S. Dharancy Withdrawal of calcineurin inhibitors (CNI) followed by mycophenolate mofetil (MMF) monotherapy after liver transplantation (LT) remains controversial due to the increased risk of acute rejection and graft loss. The aim of the present study, performed in a large cohort of liver-transplanted patients with severe CNI-induced side effects, was to assess renal function recovery, and safety in terms of liver function, of complete CNI withdrawal and replacement by MMF monotherapy. Fifty-two patients treated with MMF monotherapy for CNI-induced toxicity were analyzed. Mean estimated glomerular filtration rate (eGFR) increased significantly during the period of MMF monotherapy, from 37 ± 10 to 44.7 ± 15 mL/min/1.73 m2 at 6 months (p = 0.001) corresponding to a benefit of +17.4% in renal function. eGFR stabilized or improved in 86.5%, 81% and 79% of cases, and chronic renal dysfunction worsened in 13.5%, 19% and 21% of cases, at 6, 12 and 24 months after CNI withdrawal, respectively. Only two patients experienced acute rejection. MMF monotherapy may be efficient at reversing/stabilizing CRD, and appears relatively safe in terms of liver graft function in long-term liver-transplanted patients. However, clinicians must bear in mind the potential risk of rejection and graft loss, and should be very cautious in the management of such ,difficult-to-treat patients'. [source] Experimental study of a type 3 phosphodiesterase inhibitor on liver graft functionBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 1 2001T. Ikegami Background: The number of liver transplant recipients is increasing but donor organ shortages have become more severe. The effect of milrinone, a type 3 phosphodiesterase inhibitor (PDEI), on non-heart-beating donor grafts was evaluated using an orthotopic liver transplantation model in rats. Methods: Type 3 PDEI or normal saline (control group) was given intravenously to the donor animals for 60 min continuously (50 µg kg,1 min,1 ) before 60 min of warm ischaemia followed by cold preservation and subsequent transplantation. Survival, serum chemistry, bile output, histopathological findings and tissue cyclic 3,,5,-adenosine monophosphate (cAMP) concentrations were then compared. Results: Five of seven animals in the PDEI group were alive at 7 days, compared with only one of seven rats in the control group (P < 0·01). Serum levels of alanine aminotransferase 2 and 6 h after reperfusion, and hyaluronic acid levels 6 h after reperfusion, were significantly lower in the PDEI group than in the control group. Bile output from the transplanted graft was significantly greater in the PDEI group than in controls 2 h after reperfusion (P < 0·01). The mean necrotic area 6 h after reperfusion was also reduced in the PDEI-treated grafts (P < 0·01). cAMP levels in liver tissue at the end of both warm and cold ischaemia, and 2 and 6 h after reperfusion, were significantly higher in the PDEI group compared with those in the control group. Conclusion: Type 3 PDEI attenuated the graft injury caused by warm and cold ischaemia and subsequent reperfusion injury via an increase in intracellular cAMP levels. This treatment may be a novel pharmacological intervention for safe and efficient usage of liver grafts from non-heart-beating donors. © 2001 British Journal of Surgery Society Ltd [source] Use of lidocaine metabolism to test liver function during the long-term follow-up of liver transplant recipientsCLINICAL TRANSPLANTATION, Issue 3 2004Filoména Conti Abstract:, Background/Aims:, The aim of this study was to assess the usefulness of the monoethylglycinexylidide (MEGX) test to monitoring the long-term function of liver allografts. Methods:, MEGX production was measured prospectively in 60 consecutive liver transplant recipients undergoing their annual review. Results:, Median MEGX values in liver recipients (54 ng/mL; range 10,146) were lower than those found in healthy controls (78 ng/mL; range 44,118). MEGX values correlated negatively with alanine aminotransferase (ALT) activity (p = 0.004) and with the overall histological score (p = 0.01), and positively with sulfobromophthalein (BSP) and indocyanine green (ICG) clearances (p = 0.0002 and p = 0.002, respectively). A stepwise decline was observed with worsening liver fibrosis, from 71 ± 5 ,g/L in patients with no fibrosis to 27 ± 9 ,g/L in patients with bridging fibrosis (p = 0.002). BSP and ICG clearances correlated more closely than the MEGX test with the overall histological score (p = 0.001 and p = 0.001, respectively) and portal fibrosis (p = 0.002 and p = 0.001). Conclusions:, The measurement of MEGX formation is a simple and non-invasive method to monitor liver graft function. It may constitute a valuable tool for assessing the degree of fibrosis. [source] | ||||||||||