Protective role of tauroursodeoxycholate during harvesting and cold storage of human liver - A pilot study in transplant recipients
Protective role of tauroursodeoxycholate during harvesting and cold storage of human liver - A pilot study in transplant recipients
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DOI：
10.1097/00007890-200105150-00015
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发表时间：
2001-05-15
期刊：
影响因子：
6.2
通讯作者：
Angelico, M
中科院分区：
文献类型：
--
作者：
Falasca, L;Tisone, G;Angelico, M
背景缺血再灌注损伤是肝移植术后早期移植物功能障碍的主要原因。牛磺酸去氧胆酸（TUDCA）是一种天然的改性亲水性胆盐，在多种实验模型中可防止胆汁淤滞和肝细胞损伤，以及缺血再灌注损伤。在人肝移植实验中，研究了在肝收获和冷藏时添加TUDCA对冷藏结束、再灌注和移植后7 d的肝内和术后酶释放及肝脏组织病理学的影响。本研究对18例择期肝移植患者进行了研究，其中6例作为对照。在6例患者中，将TUDCA添加到威斯康星大学（University of Wisconsin）溶液中，使其在放置和冷藏期间达到最终浓度2mm。其中3例患者在器官移植前在供体门静脉输注TUDGA (3g)；其余3例均通过两种途径给予TUDCA。使用TUDCA未发生不良事件。经tudca处理的下腔静脉血液中天冬氨酸转氨酶在肝脏冲洗过程中的释放量显著低于对照组（P=0.05），术后第一周外周血细胞溶解酶水平也显著低于对照组（P=0.05）
Background Ischemia-reperfusion injury is a major cause of early graft dysfunction after liver transplantation. Tauroursodeoxycholic acid (TUDCA), a natural amidated hydrophilic bile salt, protects from cholestasis and hepatocellular damage in a variety of experimental models, as well as from ischemia-reperfusion injury. We investigated in the human liver transplantation setting the effect of the addition of TUDCA at time of liver harvesting and cold storage on the intra and postoperative enzyme release and liver histopathology at the end of cold storage, at reperfusion, and 7 days after transplantation.Methods. Eighteen patients undergoing elective liver transplantation were studied, including 6 serving as controls. In six patients, TUDCA was added to the University of Wisconsin solution used during hap vesting and cold storage, to reach final concentrations of 2 mM In three of these patients, TUDGA (3 g) was infused in the portal vein of the donor before organ explantation; in the other three cases, TUDCA was given through both routes.Results. The use of TUDCA did not cause adverse events. The release of aspartate aminotransferase in the inferior vena cava blood during liver flushing was significantly lower (P=0.05) in TUDCA-treated than in control grafts, as were cytolytic enzyme levels in peripheral blood during the first postoperative week (P