title: Evaluation of ischemic injury during liver procurement from non-heart-beating donors.
abstract: The aim of this study was to assess liver viability after different periods of cardiac arrest and the predictive value of two markers of ischemia-reperfusion injury.
  
  
  METHODS
  A pig liver transplantation model of non-heart-beating donors was studied. Four donor groups were designed; three groups were submitted to different periods of cardiac arrest (20, 30 and 40 min), and the fourth group served as the control group (without cardiac arrest). In the non-heart-beating donor groups, normothermic recirculation was established 30 min prior to total body cooling. Aminotransferase, alpha-glutathione-S-transferase, and hyaluronic acid determinations as well as liver biopsies, were serially performed.
  
  
  RESULTS
  Although hepatocellular function could be preserved after 40 min of cardiac arrest, histological lesions at 5 days were considered irreversible due to the presence of a necrotic biliary tract. An overall significant relationship was found between the time period of cardiac arrest (20, 30 or 40 min) and the levels of hyaluronic acid (p = 0.004) or alpha-glutathione-S-transferase (p = 0.01) obtained during liver procurement and transplantation.
  
  
  CONCLUSIONS
  The period of cardiac arrest is the determinant factor of liver viability after liver transplantation from non-heart-beating donors. As early markers of endothelial or hepatocellular damage, hyaluronic acid or alpha-glutathione-S-transferase levels may help to evaluate the ischemic injury of a potential donor.
authors.affiliation: Department of Surgery, Hospital Clinic of Barcelona, Spain.
authors.forename: J C
authors.initials: JC
authors.lastname: García-Valdecasas
authors.forename: J
authors.initials: J
authors.lastname: Tabet
authors.forename: R
authors.initials: R
authors.lastname: Valero
authors.forename: R
authors.initials: R
authors.lastname: Deulofeu
authors.forename: P
authors.initials: P
authors.lastname: Taurá
authors.forename: R
authors.initials: R
authors.lastname: Rull
authors.forename: L
authors.initials: L
authors.lastname: Capdevila
authors.forename: A
authors.initials: A
authors.lastname: Cifuentes
authors.forename: F X
authors.initials: FX
authors.lastname: González
authors.forename: M
authors.initials: M
authors.lastname: Net
authors.forename: J
authors.initials: J
authors.lastname: Beltran
authors.forename: M A
authors.initials: MA
authors.lastname: López-Boado
authors.forename: J
authors.initials: J
authors.lastname: Palacin
authors.forename: F
authors.initials: F
authors.lastname: García
authors.forename: J
authors.initials: J
authors.lastname: Visa
mesh_terms: D000410:Alanine Transaminase / Q000378:metabolism; D000818:Animals; D001219:Aspartate Aminotransferases / Q000378:metabolism; D004727:Endothelium / Q000473:pathology; D005982:Glutathione Transferase / Q000378:metabolism; D006085:Graft Survival; D006323:Heart Arrest; D006820:Hyaluronic Acid / Q000378:metabolism; D007511:Ischemia / Q000201:enzymology / Q000378:metabolism / Q000473:pathology*; D008099:Liver / Q000201:enzymology / Q000378:metabolism / Q000473:pathology*; D008102:Liver Circulation; D016031:Liver Transplantation; D011237:Predictive Value of Tests; D016019:Survival Analysis; D013552:Swine; D013997:Time Factors; D014022:Tissue Survival; D009927:Tissue and Organ Procurement
chemical_list: D006820:Hyaluronic Acid; D005982:Glutathione Transferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase