Carbon monoxide hemoglobin and bilirubin metabolism in adult living-related liver transplantation.
OBJECTIVE
Hemeoxygenase-1 produces carbon monoxide as a byproduct of hemoglobin metabolism. The present study examines the relationship between carbon monoxide production and hyperbilirubinemia following adult living-related liver transplantation with special attention to the contribution of shear stress in retarding regeneration.


METHODS
Case records from 16 patients who underwent adult living-related liver transplantation from March 1999 to May 2001 were reviewed. Patients were divided into group A (graft weight: recipient body weight ratio > or = 1) and group B (graft weight: recipient body weight ratio < 1). Clinical characteristics and outcome in the two groups were compared.


RESULTS
Total serum bilirubin concentration and the direct: total serum bilirubin concentration were higher in group B than group A (p < 0.01). Further, the carbon monoxide-hemoglobin concentration correlated with the total serum bilirubin concentration (r = 0.81, p < 0.0001) and also was higher in group B than group A (p < 0.05). The arterial: ketone body ratio rose similarly during the first week in both groups.


CONCLUSIONS
Persistent hyperbilirubinemia in small-for-size grafts and concomitant carbon monoxide-hemoglobinemia reflect both parenchymal and Kupffer cell dysfunction. The role of shear stress in the portal system and its relationship to portal hypertension are discussed.
Hirano
Kenichiro
K
Niigata University Graduate School of Medical and Dental Science Division of Digestive, and General Surgery, 1-757 Asahimachi-dori, Niigata 951-8510, Japan.
Sato
Yoshinobu
Y
Kobayashi
Takashi
T
Yamamoto
Satoshi
S
Nakatsuka
Hideki
H
Oya
Hiroshi
H
Kato
Takashi
T
Watanabe
Takaoki
T
Kameyama
Hitoshi
H
Hatakeyama
Katsuyoshi
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D001663:Bilirubin / Q000097:blood*; D001835:Body Weight / Q000502:physiology; D002248:Carbon Monoxide / Q000097:blood*; D002263:Carboxyhemoglobin / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006932:Hyperbilirubinemia / Q000503:physiopathology*; D007657:Ketone Bodies / Q000097:blood; D008099:Liver / Q000503:physiopathology; D008111:Liver Function Tests; D008115:Liver Regeneration / Q000502:physiology*; D016031:Liver Transplantation / Q000502:physiology*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009929:Organ Size / Q000502:physiology; D011183:Postoperative Complications / Q000503:physiopathology; D033081:Shear Strength; D016896:Treatment Outcome
D007657:Ketone Bodies; D002248:Carbon Monoxide; D002263:Carboxyhemoglobin; D001663:Bilirubin