Protection of reduced-size liver for transplantation
Protection of reduced-size liver for transplantation
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DOI：
10.1111/j.1600-6143.2004.00532.x
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发表时间：
2004-09-01
影响因子：
8.8
通讯作者：
Roselló-Catafau, J
中科院分区：
文献类型：
--
作者：
Franco-Gou, R;Peralta, C;Roselló-Catafau, J
可用于肝移植的器官的短缺促使了新手术技术的发展，如小尺寸肝移植。肝移植相关的缺血再灌注（I/R）损害肝脏再生。在肝肿瘤切除术的临床实践中，缺血预处理对I/R损伤是有效的。本研究评估了缺血预处理对移植小尺寸肝的影响，并试图确定其潜在的保护机制。观察原位小尺寸肝移植（ROLT）术后肝损伤及再生情况（转氨酶、增殖细胞核抗原（PCNA）标记指数、肝细胞生长因子（HGF））。研究了能量代谢、氧化应激、肿瘤坏死因子- α (TNF)和白细胞介素-6 （IL-6）可能参与肝脏再生的机制。缺血预处理降低了转氨酶水平，增加了ROLT后HGF水平和pcna阳性肝细胞百分比。这与ROLT后氧化应激的减少有关，而能量代谢和肝脏IL-6和TNF释放不变。缺血预处理对肝损伤和肝再生的益处可能是由一氧化氮介导的，至少部分是由一氧化氮介导的。这些结果提示缺血预处理在小尺寸肝移植中的潜在应用。
The shortage of available organs for liver transplantation has motivated the development of new surgical techniques such as reduced-size liver transplantation. Ischemia-reperfusion (I/R) associated with liver transplantation impairs liver regeneration. Ischemic preconditioning is effective against I/R injury in clinical practice of liver tumour resections. The present study evaluated the effect of ischemic preconditioning on reduced-size liver for transplantation and attempted to identify the underlying protective mechanisms. Hepatic injury and regeneration (transaminases, proliferating cell nuclear antigen [PCNA] labeling index, and hepatocyte growth factor [HGF]) were assessed after reduced-size orthotopic liver transplantation (ROLT). Energy metabolism, oxidative stress, tumor necrosis factor-alpha (TNF) and interleukin-6 (IL-6) were examined as possible mechanisms involved in liver regeneration. Ischemic preconditioning reduced transaminase levels and increased HGF levels and the percentage of PCNA-positive hepatocytes after ROLT. This was associated with a decrease in oxidative stress following ROLT, whereas energy metabolism and hepatic IL-6 and TNF release were unchanged. The benefits of ischemic preconditioning on hepatic injury and liver regeneration could be mediated, at least partially by nitric oxide. These results suggest a new potential application of ischemic preconditioning in reduced-size liver transplantation.