Dynamic microcirculatory changes in liver graft from non-heart-beating donor with warm ischemia injury in rat.
BACKGROUND
Since the 1990s, liver grafts from non-heart-beating donor (NHBD) have become an alternative because of the deficiency of grafts from heart-beating-donors (HBDs). Warm ischemia injury, however, directly influences the grafts' activity and functional recovery after operation. We investigated the microcirculatory change of liver graft at different warm ischemia time (WIT) in rats and determined the maximum limitation of liver graft to warm ischemia.


METHODS
According to WIT, 120 rats were divided randomly into 5 groups of 0, 15, 30, 45, 60 minutes respectively. The microcirculatory changes of their liver grafts were measured including serum level of hyaluronic acid (HA) and ultrastructural changes. After orthotopic liver transplantation (OLT), the recovery of microcirculation of the liver grafts after 24 hours, 48 hours and 3 days was observed.


RESULTS
Microcirculatory changes and function of the liver grafts became normal after reperfusion when the WIT was less than 30 minutes. In the 45-minute WI group, part of blood sinusoids was full of cytoplasmic blebs stemming from the microvilli of hepatocytes and hemocytes. The serum level of HA in each group after 45 minutes of WI recovered after reperfusion.


CONCLUSIONS
The microcirculatory change of rat liver graft is reversible when the WIT is less than 30 minutes: rat liver graft could be safely subject to warm ischemia within 30 minutes. The maximal 45 minutes of WI can be tolerated by the microcirculatory function of liver graft. After 60 minutes of WI, irreversible disturbance of microcirculation may appear.
He
Xiao-Shun
XS
Organ Transplantation Center, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China. xshe@gdvnet.com
Ma
Yi
Y
Ju
Wei-Qiang
WQ
Wu
Lin-Wei
LW
Wu
Jin-Lang
JL
Liang
Ying-Jie
YJ
Hu
Rui-De
RD
Chen
Gui-Hua
GH
Huang
Jie-Fu
JF
D000818:Animals; D006439:Hemodynamics; D006358:Hot Temperature / Q000009:adverse effects; D007511:Ischemia / Q000503:physiopathology*; D008099:Liver / Q000098:blood supply*; D016031:Liver Transplantation / Q000379:methods; D008297:Male; D008833:Microcirculation / Q000503:physiopathology*; D023421:Models, Animal; D051381:Rats; D017207:Rats, Sprague-Dawley; D020127:Recovery of Function; D015427:Reperfusion Injury / Q000503:physiopathology*; D013997:Time Factors; D014019:Tissue Donors; D019737:Transplants