L-arginine reduces liver and biliary tract damage after liver transplantation from non-heart-beating donor pigs.
BACKGROUND
To evaluate whether L-arginine reduces liver and biliary tract damage after transplantation from non heart-beating donor pigs.


METHODS
Twenty-five animals received an allograft from non-heart-beating donors. After 40 min of cardiac arrest, normothermic recirculation was run for 30 min. The animals were randomly treated with L-arginine (400 mg x kg(-1) during normothermic recirculation) or saline (control group). Then, the animals were cooled and their livers were transplanted after 6 hr of cold ischemia. The animals were killed on the 5th day, liver damage was assessed on wedged liver biopsies by a semiquantitative analysis and by morphometric analysis of the necrotic areas, and biliary tract damage by histological examination of the explanted liver.


RESULTS
Seventeen animals survived the study period. The histological parameters assessed (sinusoidal congestion and dilatation, sinusoidal infiltration by polymorphonuclear cells and lymphocytes, endothelitis, dissociation of liver cell plates, and centrilobular necrosis) were significantly worse in the control group. The necrotic area affected 15.9 +/- 14.5% of the liver biopsies in the control group and 3.7 +/- 3.1% in the L-arginine group (P<0.05). Six of eight animal in the control group and only one of eight survivors in the L-arginine group developed ischemic cholangitis (P<0.01). L-Arginine administration was associated with higher portal blood flow (676.9 +/- 149.46 vs. 475.2 +/- 205.6 ml x min x m(-2); P<0.05), higher hepatic hialuronic acid extraction at normothermic recirculation (38.8 +/- 53.7% vs. -4.2 +/- 18.2%; P<0.05) and after reperfusion (28.6 +/- 55.5% vs. -10.9 +/- 15.5%; P<0.05) and lower levels of alpha-glutation-S-transferase at reperfusion (1325 +/- 1098% respect to baseline vs. 6488 +/- 5612%; P<0.02).


CONCLUSIONS
L-Arginine administration during liver procurement from non heart beating donors prevents liver and biliary tract damage.
Valero
R
R
Department of Anesthesiology, Hospital Clínic of Barcelona, Spain.
García-Valdecasas
J C
JC
Net
M
M
Beltran
J
J
Ordi
J
J
González
F X
FX
López-Boado
M A
MA
Almenara
R
R
Taurá
P
P
Elena
M
M
Capdevila
L
L
Manyalich
M
M
Visa
J
J
D000818:Animals; D001120:Arginine / Q000494:pharmacology*; D001659:Biliary Tract / Q000098:blood supply*; D002315:Cardiopulmonary Bypass; D004734:Energy Metabolism; D005982:Glutathione Transferase / Q000097:blood; D006323:Heart Arrest; D006820:Hyaluronic Acid / Q000097:blood; D008099:Liver / Q000098:blood supply* / Q000378:metabolism / Q000473:pathology; D008102:Liver Circulation / Q000502:physiology; D016031:Liver Transplantation / Q000473:pathology / Q000502:physiology*; D010100:Oxygen / Q000378:metabolism; D012039:Regional Blood Flow / Q000502:physiology; D015427:Reperfusion Injury / Q000473:pathology / Q000517:prevention & control; D013552:Swine; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000379:methods*
D006820:Hyaluronic Acid; D001120:Arginine; D005982:Glutathione Transferase; D010100:Oxygen