Study on the influences of injurys by ischemia and reperfusion to retrograde perfusion in standard orthotopic liver transplantations

doi:10.3877/cma.j.issn.1674-0793.2007.02.010

Abstract

Abstract:

Objective

Study on the influences of injurys by ischemia and reperfusion to retrograde perfusion in orthotopic liver transplantations.

Methods

Thirty five standard orthotopic liver transplantation patients were randomly divided into experimental group and control group.Retrograde perfusion via caval veins were performed in experimental group(17 cases)and normal reperfusions via portal veins were performed in control group(18 cases).The re-warm ischemia time,ALT,GGT,TB and PT in patients'serum were tested in the two groups respectively at one hour,1 day,2,3,5 and 7 days after operation.Concentrations of TNF-αand IL-1 in the caval veins were also tested two hours after the grafts transplanted into the patients.The ratio of hydropic degeneration and necrotic hepatocytes were detected under the light microscope and the morphologic changes of hepatocytes were detected under light and electro microscope respectively.

Results

The re-warm ischemia time of experimental group was remarkably shorter than that of control group(P<0.05).For serum TB,the experimental group was remarkably lower than the control group 1 hour,1 and 2 days after operation(P<0.05),but there were no significant differences between the two groups 3,5 and 7 days after operation.For serum ALT,the experimental group was remarkably lower than the control group 1 and 2 days after operation(P<0.05),but there were no significant differences between the two groups 1 hour,3,5 and 7 days after operation.For serum GGT,the experimental group was remarkably lower than the control group 1hour,1and 3 days after operation(P<0.05),but there were no significant differences between the two groups 2,5 and 7 days after operation.For PT,there were no significent differences between the two groups after operation.Concentrations of TNF-αand IL-1 in the caval veins of experimental group were remarkably lower than those of control group two hours after the grafts transplanted into the patients(P<0.05).The injury by ischemia and reperfusion,ratio of hydropic degeneration and hepatocyte necrosis for experimental group were remakably lighter than control group(P<0.05).

Conclusion

The injurys caused by ischemia and reperfusion might be reduced and the graft functions might be improved by using method of retrograde perfusion in orthotopic liver transplantations.

Key words: standard orthotopic liver transplantation, retrograde perfusion, reperfusion ischemia and reperfusion injury

Lizhi Lv, Yi Jiang, Huanzhang Hu, Xiaojin Zhang, Kun Zhang, Fang Yang, Qiucheng Cai, Yongbiao Chen, Fan Pan, Shaogeng Zhang. Study on the influences of injurys by ischemia and reperfusion to retrograde perfusion in standard orthotopic liver transplantations[J]. Chinese Archives of General Surgery(Electronic Edition), 2007, 01(02): 101-105.

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Figures/Tables 5

References 17

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组别	年龄(岁)	手术时间(h)	供肝脂肪变性百分比(%)	供肝冷缺血时间(h)
对照组(n=18)	46.61±9.10	8.31±1.26	21.32±5.12	9.25±2.45
试验组(n=17)	43.29±10.82	8.09±0.73	23.17±4.32	9.62±2.47
t值	0.9841	0.6270	0.6211	-0.4417
P值	0.3322	0.5358	0.5715	0.6616

组别	年龄(岁)	手术时间(h)	供肝脂肪变性百分比(%)	供肝冷缺血时间(h)
对照组(n=18)	46.61±9.10	8.31±1.26	21.32±5.12	9.25±2.45
试验组(n=17)	43.29±10.82	8.09±0.73	23.17±4.32	9.62±2.47
t值	0.9841	0.6270	0.6211	-0.4417
P值	0.3322	0.5358	0.5715	0.6616

组别	性别		小计
组别	男	女	小计
对照组	14	4	18
试验组	14	3	17
小计	28	7	35

组别	性别		小计
组别	男	女	小计
对照组	14	4	18
试验组	14	3	17
小计	28	7	35

组别	原发病		小计
组别	肝癌	肝硬化	小计
对照组	8	10	18
试验组	7	10	17
小计	15	20	35

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