Hyperbaric oxygen therapy reduces the severity of ischaemia, preservation and reperfusion injury in a rat model of liver transplantation.
BACKGROUND
Approaches to increase organ availability for orthotopic liver transplantation (OLT) often result in the procurement of marginal livers that are more susceptible to ischaemia, preservation and reperfusion injury (IPRI).


METHODS
The effects of post-OLT hyperbaric oxygen (HBO) therapy on IPRI in a syngeneic rat OLT model were examined at various time-points. The effects of IPRI and HBO on hepatocyte necrosis, apoptosis, proliferation, and sinusoidal morphology and ultrastructure were assessed.


RESULTS
Post-OLT HBO therapy significantly reduced the severity of IPRI; both apoptosis [at 12 h: 6.4 ± 0.4% in controls vs. 1.6 ± 0.7% in the HBO treatment group (p < 0.001); at 48 h: 2.4 ± 0.2% in controls vs. 0.4 ± 0.1% in the HBO treatment group (p < 0.001)] and necrosis [at 12 h: 18.7 ± 1.8% in controls vs. 2.4 ± 0.4% in the HBO treatment group (p < 0.001); at 48 h: 8.5 ± 1.3% in controls vs. 3.4 ± 0.9% in the HBO treatment group (P= 0.019)] were decreased. Serum alanine transaminase was reduced [at 12 h: 1068 ± 920 IU/l in controls vs. 370 ± 63 IU/l in the HBO treatment group (P= 0.030); at 48 h: 573 ± 261 IU/l in controls vs. 160 ± 10 IU/l in the HBO treatment group (P= 0.029)]. Treatment with HBO also promoted liver regeneration [proliferation at 12 h: 4.5 ± 0.1% in controls vs. 1.0 ± 0.3% in the HBO treatment group (p < 0.001); at 48 h: 8.6 ± 0.7% in controls vs. 2.9 ± 0.2% in the HBO treatment group (p < 0.01)] and improved sinusoidal diameter and microvascular density index.


CONCLUSIONS
Hyperbaric oxygen therapy has persistent positive effects post-OLT that may potentially transfer into clinical practice.
Department of Surgery, The University of Melbourne, Austin Health, Studley Road, Heidelberg, Victoria, Australia.
Nhut Quang
NQ
Tran
Caterina
C
Malcontenti-Wilson
Soukena
S
Hammoud
Ian
I
Millar
Chris
C
Christophi
Vijayaragavan
V
Muralidharan
D000818:Animals; D017209:Apoptosis; D015415:Biomarkers / Q000097:blood; D049109:Cell Proliferation; D004195:Disease Models, Animal; D006931:Hyperbaric Oxygenation; D008099:Liver / Q000098:blood supply* / Q000601:surgery* / Q000648:ultrastructure; D008115:Liver Regeneration; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008855:Microscopy, Electron, Scanning; D046529:Microscopy, Electron, Transmission; D009336:Necrosis; D051381:Rats; D011917:Rats, Inbred Lew; D015427:Reperfusion Injury / Q000097:blood / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D012720:Severity of Illness Index; D013997:Time Factors
D015415:Biomarkers