[The role of oxidative stress and arterial blood supply in the transplanted liver function].
BACKGROUND
Reperfusion injury and hepatic artery thrombosis are major causes of graft failure after liver transplantation. The magnitude of oxidative stress increases after reperfusion and the appearance of an arterial thrombosis presents a higher risk for the graft and patient survival.


OBJECTIVE
The aim of the study was to detect the level of oxidative stress in the perioperative period of transplantation.


METHODS
Clinical documentations of 32 patients were investigated and the level of myeloperoxidase (MPO) was measured for the monitoring of the oxidative stress.


RESULTS
The mean age of the patients was 43 years and hepatitis C cirrhosis was the most common indication (14 cases, 43%). Two retransplantations were done. In 24 cases (75%) the primary graft functions and patient survival were good. Eight patients died, in two cases because of acute liver failure, in two cases due to primary non function and in four cases due to late complications. The incidence of hepatic artery thrombosis was 11% (4 cases) and the incidence of acute rejection was 35% (12 cases). The level of MPO was higher (65 ng/ml) in all patients before operation. After the first 48 hours this level increased significantly (p < 0.0001) up to the mean level of 123 ng/ml and decreased after one week. In the cases with acute liver failure and hepatic artery thrombosis high levels of MPO were measured.


CONCLUSIONS
This study provides evidence of increased oxidative stress before liver transplantation. The magnitude of these changes increased after operation, mostly in cases with acute liver failure and hepatic artery thrombosis. Reducing the reperfusion injury and performing an "ideal" arterial supply for the liver-graft present better survival.
Kóbori
László
L
Semmelweis Egyetem, Altalános Orvostudományi Kar, Transzplantációs és Sebészeti Klinika, Budapest. koblac@hotmail.com
Sárváry
Enikö
E
Nemes
Balázs
B
Lakatos
Márta
M
Fehérvári
Imre
I
Görög
Dénes
D
Dallos
Gábor
G
Gerlei
Zsuzsa
Z
Fazakas
János
J
Tóth
Tibor
T
Lengyel
Gabriella
G
Fehér
János
J
Járay
Jenö
J
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology; D006499:Hepatic Artery; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D015994:Incidence; D008099:Liver / Q000098:blood supply* / Q000201:enzymology / Q000378:metabolism*; D008107:Liver Diseases / Q000201:enzymology / Q000378:metabolism* / Q000401:mortality / Q000601:surgery; D017114:Liver Failure, Acute / Q000453:epidemiology; D016031:Liver Transplantation / Q000401:mortality; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress; D009195:Peroxidase / Q000097:blood*; D011446:Prospective Studies; D013927:Thrombosis / Q000453:epidemiology; D013997:Time Factors
D009195:Peroxidase