Nondestructive and real-time evaluation of liver viability in brain dead donor for liver transplantation using near-infrared spectroscopy.
A reliable and less-invasive method is currently desired to assess the hemodynamic and functional alteration associated with brain death in the organs of donor candidates. Near-infrared spectroscopy (NIRs) was applied to rat liver in brain-dead donors for assessing tissue oxygenation and intracellular energy metabolism as a means of monitoring the liver viability in the brain-dead donor. Brain-dead rats were divided into 4 according to doses of epinephrine and vasopressin administered. Arterial ketone bodies ratio (AKBR), hyaluronic acid (HA), and NIRs monitoring of a liver graft were performed in the brain-dead phase before the grafts were transplanted into syngeneic rats. NIRs monitoring of oxygenated hemoglobin (Hb) and cytochrome aa3 oxidase (Cytaa3) redox state reflected changes in the hepatic microcirculation and intracellular oxygenation. The administration of high-dose epinephrine proved to be contraindicated due to catecholamine-induced hypoxic stress, while combined administration of adrenaline and vasopressin at an optimal dose rate was beneficial for preservation of the liver viability. The data obtained by NIRs were significantly correlated with the 7-day survival of recipients after liver transplantation. Thus, we conclude that NIRs is a sensitive and nondestructive method for monitoring alterations in the viability of brain-dead liver and can predict liver graft outcome.
Fan
X H
XH
Second Department of Surgery, Hiroshima University, School of Medicine, Japan. fanxiaohu@rocketmail.com
Asahara
T
T
Ohdan
H
H
Miyata
Y
Y
Shibata
S
S
Dohi
K
K
D000818:Animals; D001926:Brain Death; D004569:Electroencephalography; D003576:Electron Transport Complex IV / Q000032:analysis; D006085:Graft Survival; D008099:Liver; D016031:Liver Transplantation / Q000502:physiology*; D008297:Male; D023421:Models, Animal; D009926:Organ Preservation / Q000379:methods; D010108:Oxyhemoglobins / Q000032:analysis; D051381:Rats; D011917:Rats, Inbred Lew; D015203:Reproducibility of Results; D013055:Spectrophotometry, Infrared / Q000379:methods; D013997:Time Factors; D014019:Tissue Donors
D010108:Oxyhemoglobins; D003576:Electron Transport Complex IV