[Effect of nutritional status of the donor on the quality of hepatic graft. Value of restoration of glycogenic reserves of the donor].
Initial function of the graft is an essential factor for successful liver transplantation. The aim of this study was to evaluate the influence of the nutritional status of the donor on hepatic graft quality at reperfusion. Livers (n = 41) were taken from pigs normally fed or fasted for 24 h or fasted for 24 h and conditioned for 2 hours with a solution containing glucose, fructose and glutamine. The quality of liver grafts was evaluated using an original, blood-free isolated perfusion model, after 8 h cold storage, or after 15 min warm ischemia performed prior to harvesting. The hepatic concentration of glycogen and ATP, measured from in vivo biopsies, was decreased in fasted animals (P less than 0.05 vs fed) and restored by nutritional conditioning (P less than 0.05 vs fasted). At the time of reperfusion following 8 h cold ischemia, the liberation of aminotransferases and lactate dehydrogenase was elevated in livers coming from fasted animals (P less than 0.05 vs fed) and restored to fed levels after nutritional conditioning (P less than 0.01 vs fasted). After 15 min of warm ischemia, the bile secretion during the reperfusion period was decreased in the 24 h fasted livers (P less than 0.01 vs fed) and reestablished after nutritional conditioning (P less than 0.01 vs fasted). Perfusion of the donor liver, in the 2 h preceding harvest, with a solution of glucose plus neoglucogenic precursors enhances the quality of the liver graft at the time of reperfusion.(ABSTRACT TRUNCATED AT 250 WORDS)
Pattou
F
F
Laboratoire de Chirurgie Expérimentale, Fondation Transplantation, Hautepierre Strasbourg.
Boudjema
K
K
Kerr-Conte
J
J
Wolf
P
P
Jaeck
D
D
Cinqualbre
J
J
D000818:Animals; D001646:Bile / Q000378:metabolism; D005260:Female; D008099:Liver / Q000201:enzymology / Q000378:metabolism*; D008112:Liver Glycogen / Q000032:analysis / Q000378:metabolism*; D016031:Liver Transplantation / Q000379:methods*; D009752:Nutritional Status / Q000502:physiology*; D009926:Organ Preservation / Q000379:methods*; D011188:Potassium / Q000032:analysis / Q000378:metabolism; D015424:Reperfusion / Q000379:methods; D013552:Swine / Q000378:metabolism; D014019:Tissue Donors
D008112:Liver Glycogen; D011188:Potassium
Influence du statut nutritionnel du donneur sur la qualité du greffon hépatique. Intérêt de la restauration des réserves glycogéniques du donneur.