Efficacy of prostacyclin analogue (OP-2507) in viable hepatic grafts from pigs with non-beating hearts.
We investigated whether the stable prostacyclin analogue (OP-2507; OP) would ameliorate warm ischemia-related injury of the liver graft under conditions of a nonbeating heart. Thirty-six mongrel pigs were arranged into 3 groups of 6 pairs. Group 1 pigs underwent orthotopic liver transplantation from heart-beating donors (HBD). In group 2, animals received liver grafts from nonheart-beating donors (NHBD), defined as 30 min of cardiac arrest. Group 3 pigs received grafts from NHBD, but the donor had been pretreated with OP by intraportal infusion (2 microg/kg x min for 30 min immediately before the induction of cardiac arrest). The grafts were preserved at 4 degrees C in Euro-Collins solution in which OP was dissolved at 200 microg/l. Five-day survival rates after transplantation improved significantly in OP-treated animals (3/6, for group 3), compared with 0/6 for group 2 (P < 0.05, generalized Wilcoxon test). Five of 6 animals survived more than 5 days in the HBD group (group 1). Although the serum transaminase activities and bile production did not differ in the early phase of recirculation among the groups, there was a significant improvement in the hepatic microcirculatory environment in the surviving groups (groups 1 and 3). Analysis of arterial prostanoid levels showed a substantial suppression of PGE2 release by OP treatment following reperfusion. Our data indicate that a stable prostacyclin analogue can be clinically useful for expanding the donor pool by improving the quality of the liver graft.
Kim
Y I
YI
Department of Surgery I, Oita Medical University Hasama-cho, Japan.
Kawano
K
K
Goto
S
S
Yoshida
T
T
Kamada
N
N
D000818:Animals; D001639:Bicarbonates / Q000097:blood; D001646:Bile / Q000378:metabolism; D011464:Epoprostenol / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use*; D005260:Female; D006085:Graft Survival / Q000187:drug effects* / Q000502:physiology; D006324:Heart Arrest, Induced; D006982:Hypertonic Solutions; D007262:Infusions, Intravenous; D008099:Liver; D016031:Liver Transplantation / Q000379:methods / Q000473:pathology / Q000502:physiology*; D008833:Microcirculation / Q000187:drug effects / Q000502:physiology; D009926:Organ Preservation; D019188:Organ Preservation Solutions; D011169:Portal Vein; D012039:Regional Blood Flow / Q000187:drug effects; D015427:Reperfusion Injury / Q000517:prevention & control*; D013552:Swine
D001639:Bicarbonates; C037096:Euro-Collins' solution; D006982:Hypertonic Solutions; D019188:Organ Preservation Solutions; C049453:OP 2507; D011464:Epoprostenol