title: Beta-galactosidase as a marker of ischemic injury and a mechanism for viability assessment in porcine liver transplantation.
abstract: Glycohydrolases are a group of enzymes contained predominantly within lysosomes, which are released during Kupffer cell activation or death. One of these, beta-galactosidase, has been proposed as a marker of ischemia-reperfusion injury in the liver because Kupffer cell activation represents a primary event in the injurious reperfusion cascade. In this study, we compared B-galactosidase with more traditional indicators of liver injury and function in a porcine model of liver preservation. Porcine livers were allocated into two groups: group C (n = 5), preserved in University of Wisconsin solution by standard cold storage for 24 hours, and group W (n = 5), perfused with oxygenated autologous blood on an extracorporeal circuit for 24 hours. Both groups were subsequently tested on the circuit during a 24-hour reperfusion phase. The perfusate was sampled for levels of beta-galactosidase, as well as traditional markers of liver injury and function. A sharp increase in beta-galactosidase levels was seen on reperfusion of cold preserved livers to a level of 1,900 IU/mL. This contrasted dramatically with normothermically preserved livers, in which the level never exceeded 208 IU/mL (P =.002). beta-Galactosidase levels showed much earlier and greater increases compared with transaminase levels in livers injured by ischemia. A rapid elevation in beta-galactosidase levels corresponded well with poor liver function and more liver injury. Measurement of beta-galactosidase is a simple test that quantifies ischemia-reperfusion injury of preserved livers. It is more sensitive than transaminases, with faster and larger increases in levels after ischemic injury. It can be useful in assessing the viability of a liver during machine preservation.
authors.affiliation: Nuffield Department of Surgery, University of Oxford, Oxford, England.
authors.forename: Shawn D
authors.initials: SD
authors.lastname: St  Peter
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Imber
authors.forename: Inigo Lopez
authors.initials: IL
authors.lastname: De Cenarruzabeitia
authors.forename: James
authors.initials: J
authors.lastname: McGuire
authors.forename: Tim
authors.initials: T
authors.lastname: James
authors.forename: Richard
authors.initials: R
authors.lastname: Taylor
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Friend
mesh_terms: D000818:Animals; D005112:Extracorporeal Circulation; D008099:Liver / Q000098:blood supply*; D016031:Liver Transplantation; D023421:Models, Animal; D009926:Organ Preservation; D015427:Reperfusion Injury / Q000175:diagnosis*; D013552:Swine; D001616:beta-Galactosidase / Q000378:metabolism*
chemical_list: D001616:beta-Galactosidase