Graft dysfunction following liver transplantation: role of free radicals.
OBJECTIVE
Following orthotopic liver transplantation primary graft non-function occurs in about 10% of patients, and survival depends on early retransplantation. The aetiology has yet to be defined, but reperfusion injury as a result of free radical production has been considered as a possible mechanism. In this study we looked for evidence of free radical generation intraoperatively and assessed the relationship between free radical production and graft function.


RESULTS
Twenty-one patients (M:F 10:11, mean age; 53 +/- 3.8 years) who underwent liver transplantation for end-stage liver disease were studied. Free radical activity increased significantly following reperfusion, as shown by: (i) the diene conjugated method, where the percentage molar ratio increased from a baseline of 10.87 +/- 0.78% to 24.42 +/- 7.8% (p < 0.01), and (ii) by electron paramagnetic resonance, where a more than a twofold rise in radical concentration was detected (p < 0.05). The increase in free radical activity detected by the diene conjugated method was significantly higher in patients with poor outcome as compared with those who had uneventful recovery (p < 0.01).


CONCLUSIONS
Free radical activity is increased following reperfusion of liver graft during transplantation, and the magnitude of the rise is related to the severity of graft dysfunction.
Bzeizi
K I
KI
Scottish Liver Transplant Unit, Royal Infirmary of Edinburgh, UK.
Dawkes
R
R
Dodd
N J
NJ
Plevris
J N
JN
Hayes
P C
PC
D015415:Biomarkers; D005260:Female; D005609:Free Radicals; D006085:Graft Survival / Q000502:physiology*; D006801:Humans; D007430:Intraoperative Care / Q000379:methods*; D016014:Linear Models; D017093:Liver Failure / Q000601:surgery*; D016031:Liver Transplantation / Q000502:physiology*; D008297:Male; D008875:Middle Aged
D015415:Biomarkers; D005609:Free Radicals