Hepatic xanthine levels as viability predictor of livers procured from non-heart-beating donor pigs.
BACKGROUND
The aim of the present study was to evaluate hepatic content of adenine nucleotides and their degradation products in non-heart-beating donor (NHBD) pigs and its relationship with recipient survival.


METHODS
Thirty animals were transplanted with an allograft from NHBDs. After warm ischemia (WI) time (20, 30, or 40 min), cardiopulmonary bypass and normothermic recirculation (NR) were run for 30 min. Afterward, the animals were cooled to 15 degrees C and liver procurement was performed.


RESULTS
Survival rate was 100% in the 20WI, 70% in the 30WI, and 50% in the 40WI. Livers from non-surviving animals had higher levels of xanthine after NR than livers from surviving animals. Logistic regression analysis revealed that xanthine at the end of NR was the only variable able to predict survival with a calculated sensitivity of 80% and a specificity of 60%. Prolongation of warm ischemic period leaded to a greater xanthine accumulation as well as increased plasma alpha-glutathione S-transferase levels at reperfusion. Xanthine at NR and alpha-glutathione S-transferase at reperfusion significantly correlated, indicating that donor xanthine contributes to some extent to the severity of the lesion by ischemia-reperfusion.


CONCLUSIONS
It is suggested that xanthine content in the donor is able to predict survival after transplantation. Xanthine is significantly involved in the hepatic lesion elicited by warm ischemia and subsequent ischemia-reperfusion associated to liver transplantation from a NHBD.
Net
M
M
Department of Anesthesiology, Biochemistry and Transplant Coordination of the Hospital Clínic de Barcelona, Universitat de Barcelona, Spain.
Valero
R
R
Almenara
R
R
Rull
R
R
Gonzalez
F J
FJ
Taurá
P
P
Lopez-Boado
M A
MA
Deulofeu
R
R
Elena
M
M
Capdevila
L
L
Cabrer
C
C
Visa
J
J
García-Valdecasas
J C
JC
D000818:Animals; D004734:Energy Metabolism; D006085:Graft Survival / Q000187:drug effects / Q000502:physiology; D006323:Heart Arrest / Q000378:metabolism; D019271:Hypoxanthine / Q000378:metabolism; D008099:Liver / Q000737:chemistry*; D016031:Liver Transplantation / Q000276:immunology* / Q000401:mortality; D016015:Logistic Models; D015996:Survival Rate; D013552:Swine; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000379:methods*; D019820:Xanthine / Q000378:metabolism*
D019820:Xanthine; D019271:Hypoxanthine