Effects of hemodilution with a hemoglobin-based oxygen carrier (HBOC-201) on ischemia/reperfusion injury in a model of partial warm liver ischemia of the rat.
BACKGROUND
Ischemia/reperfusion injury is an unavoidable complication in liver surgery and transplantation. Hemodilution with colloids can reduce postischemic injury but limits oxygen transport. Hemoglobin-based oxygen carriers have been evaluated as blood substitute and provide a plasma-derived oxygen transport. It was the aim of our study to evaluate the combined benefits of hemodilution with a better oxygen supply to reperfused liver tissue by the use of HBOC-201 (Hemopure).


METHODS
A model of partial warm liver ischemia in the rat was used. One group served as untreated control, the other groups were hemodiluted either with Ringer's lactate, Dextran-70, HBOC-201 or a mixture of Dextran and HBOC-201. After reperfusion, intravital microscopy studies were done and tissue pO(2) levels and transaminases measured. Statistical analysis was done by one- and two-way ANOVA, followed by pairwise comparison.


RESULTS
Hemodilution with Ringer's lactate did not show any improvement compared to the control group. Dextran and HBOC group were superior to the Ringer and control animals in all parameters studied. Leucocyte adherence in postsinusoidal venules improved from 569.03+/-171.87 and 364.52+/-167.32 in control and Ringer group to 131.68+/-58.34 and 68.44+/-20.31/mm(2) endothelium in Dextran and HBOC group (p<0.001). Concerning tissue pO(2) levels, HBOC (23.4+/-5.0 mmHg) proved to be superior to Dextran (7.9+/-4.4 mmHg; p=0.007).


CONCLUSIONS
HBOC was equivalent to Dextran in reducing I/R injury in the liver, but improved oxygenation of postreperfusion liver tissue.
Zapletal
Christina
C
Department of Surgery, Johann Wolfgang Goethe-University, Frankfurt/Main, Germany. czap@gmx.net
Bode
Alexander
A
Lorenz
Matthias W
MW
Gebhard
Martha-Maria
MM
Golling
Markus
M
D000410:Alanine Transaminase / Q000378:metabolism; D000818:Animals; D001219:Aspartate Aminotransferases / Q000378:metabolism; D001802:Blood Substitutes / Q000494:pharmacology*; D002448:Cell Adhesion / Q000187:drug effects; D004195:Disease Models, Animal; D042783:Endothelial Cells / Q000187:drug effects; D006438:Hemodilution / Q000379:methods*; D006454:Hemoglobins / Q000494:pharmacology*; D007962:Leukocytes / Q000166:cytology / Q000187:drug effects; D008099:Liver / Q000098:blood supply* / Q000378:metabolism; D010100:Oxygen / Q000378:metabolism; D051381:Rats; D015427:Reperfusion Injury / Q000188:drug therapy* / Q000378:metabolism; D052096:Warm Ischemia / Q000009:adverse effects*
D001802:Blood Substitutes; D006454:Hemoglobins; C096798:HBOC 201; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D010100:Oxygen