Predicting the viability of grafted livers in rats through a rapid and sensitive metabolic indicator assessed by 31P-NMR spectroscopy.
The present study was undertaken to clarify whether a correlation exists between the hepatic ratio of the beta-phosphorus moiety of ATP (beta-ATP) to inorganic phosphate (Pi), measured by 31P nuclear magnetic resonance spectroscopy 1 h after the reestablishment of portal blood flow, and the survival rate of rats following liver transplantation. This ratio was compared with the arterial ketone body ratio [AKBR (acetoacetate/3-hydroxybutyrate)], which is accepted as a reliable indicator of liver viability. After the transplantation of fresh livers, the 1-week survival rate was 92% and the beta-ATP/Pi ratio was 64% of the normal level. When the liver grafts were subjected to warm ischemia for 25 min or 45 min prior to harvesting, the 1-week survival rate decreased to 43% and 0%, respectively, and the beta-ATP/Pi ratio dropped to 31% and 18% of the normal level, respectively. On the other hand, the AKBR was about 25% of the normal level after transplantation of fresh livers, while it was 37% and 48% after transplantation with 25 min and 45 min of warm ischemia, respectively. However, 4 h after the reestablishment of portal blood flow, the AKBR correlated with the beta-ATP/Pi ratio in both the fresh graft group and the 45-min warm ischemic damage group. These results show that the beta-ATP/Pi ratio provides an accurate evaluation of a graft viability even at an extremely early stage following liver transplantation, and should prove useful for the early diagnosis of primary graft nonfunction after liver transplantation.
Yang
M
M
First Department of Surgery, Fukui Medical School, Japan.
Shimada
H
H
Kobayashi
T
T
Niimoto
S
S
Nakagawara
G
G
D000255:Adenosine Triphosphate / Q000378:metabolism; D000818:Animals; D004734:Energy Metabolism; D006085:Graft Survival; D007511:Ischemia / Q000378:metabolism; D007657:Ketone Bodies / Q000097:blood; D008099:Liver / Q000098:blood supply / Q000378:metabolism*; D016031:Liver Transplantation; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D010710:Phosphates / Q000378:metabolism; D010758:Phosphorus; D011237:Predictive Value of Tests; D051381:Rats; D017208:Rats, Wistar
D007657:Ketone Bodies; D010710:Phosphates; D010758:Phosphorus; D000255:Adenosine Triphosphate