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.
First Department of Surgery, Fukui Medical School, Japan.
M
M
Yang
H
H
Shimada
T
T
Kobayashi
S
S
Niimoto
G
G
Nakagawara
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