Impact of ischemia/reperfusion on transplanted livers procured from elderly cadaveric donors.
The increasing number of clinical indications for liver transplantation has forced physicians to use livers procured from elderly cadaveric donors to expand the graft pool. However, the degree of ischemia/reperfusion damage in elderly livers remains poorly investigated. In this study, the outcomes of livers procured from a group (I) of young donors (n=12; 38 +/- 12 years; range: 21-58) were compared with a group (II) from elderly donors (n=7; 68 +/- 7 years; range: 62-84) for changes in reduced glutathione, the main hepatic free radical scavenger. Reduced and oxidized glutathione were assayed by high performance liquid chromatography in liver biopsies performed just before cold ischemia and during early reperfusion. A significant decrease in reduced glutathione was observed at the time of reperfusion in both groups I (P=.0195) and II (P=.002). Before cold ischemia and during early reperfusion, no differences between young versus elderly donors were noted in the oxidized/reduced glutathione ratio, in conventional graft function markers or in liver-related hemostatic parameters. Comparable glutathione contents were measured at the time of early reperfusion in livers obtained from young and elderly cadaveric donors, suggesting that livers procured from elderly donors might be adequately protected against ischemia/reperfusion damage.
Santori
G
G
Department of Transplantation, S. Martino University Hospital, University of Genoa, Genoa, Italy. gsantori@medscape.com
Andorno
E
E
Morelli
N
N
Gianelli Castiglione
A
A
Casaccia
M
M
Saltalamacchia
L
L
Panaro
F
F
Cottalasso
D
D
Valente
U
U
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002102:Cadaver; D006801:Humans; D008099:Liver / Q000098:blood supply / Q000473:pathology; D008111:Liver Function Tests; D016031:Liver Transplantation / Q000473:pathology / Q000502:physiology*; D008875:Middle Aged; D015427:Reperfusion Injury; D014019:Tissue Donors; D020858:Tissue and Organ Harvesting / Q000379:methods*; D016896:Treatment Outcome