Graft function and survival depend primarily on host factors in compromised recipient models of orthotopic liver transplantation in the rat.
BACKGROUND
Experimental models of liver transplantation use normal recipients, although most patients undergoing liver transplantation suffer from acute or chronic liver failure. This study was designed to analyze the outcome of orthotopic liver transplantation in compromised rat hosts.


METHODS
Recipient animals were either rats with D-galactosamine-induced acute or rats with chronic liver failure secondary to common bile duct ligation. Liver damage was evaluated by monitoring enzymes, bilirubin, ammonia levels, prothrombin, thrombin time, and cytokines. In vivo function of hepatocytes and sinusoidal endothelial cells were evaluated by indocyanine green and hyaluronic acid uptake. Transplantation was performed in normal, acute, and chronic liver failure rats at different time points using either freshly harvested or cold-preserved syngeneic livers.


RESULTS
Survival with fresh grafts decreased significantly when transplants were performed 48 hr after the induction of acute liver failure. No rats with acute liver failure survived transplantation with grafts stored for 12 or 24 hr although in chronic failure survival was more 80%. Survival of acute liver failure rats receiving 6 hr preserved grafts was 16.6% compared with 83.3% observed with fresh grafts transplanted at the same time point after D-galactosamine injection. Elevated tumor necrosis factor-alpha and interleukin-1beta levels as well as impaired sinusoidal endothelial cell function were detected in acute liver failure rats with 6 h preserved grafts.


CONCLUSIONS
These results suggest that preoperative status and different host factors have a significant effect on outcome and graft function after liver transplantation in rats.
Wang
L
L
The Recanati/Miller Transplantation Institut, The Mount Sinai School of Medicine, New York, NY 10029, USA.
Roayaie
S
S
Basile
J
J
Florman
S
S
Liu
J
J
Tarcsafalvi
A
A
Boros
P
P
Miller
C M
CM
D000818:Animals; D002908:Chronic Disease; D016207:Cytokines / Q000378:metabolism; D006085:Graft Survival; D006820:Hyaluronic Acid / Q000378:metabolism; D016867:Immunocompromised Host / Q000502:physiology*; D007208:Indocyanine Green / Q000378:metabolism; D017093:Liver Failure / Q000601:surgery; D017114:Liver Failure, Acute / Q000601:surgery; D016031:Liver Transplantation / Q000276:immunology* / Q000502:physiology*; D008297:Male; D023421:Models, Animal; D009926:Organ Preservation; D051381:Rats; D011917:Rats, Inbred Lew; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D016207:Cytokines; D014409:Tumor Necrosis Factor-alpha; D006820:Hyaluronic Acid; D007208:Indocyanine Green