Impact of endotoxin measured by an endotoxin activity assay during liver transplantation.
BACKGROUND
Endotoxin (Et) in the portal vein blood is processed by the hepatic reticuloendothelial system. Thus, it is possible that the Et kinetics of the peripheral venous blood may be useful as a biological index that can be used to evaluate liver function. In this study, we measured Et using the endotoxin activity assay in peripheral venous blood during living donor liver transplantation (LDLT), to study its clinical significance.


METHODS
Subjects were 17 patients who underwent LDLT. In the perioperative peripheral venous blood, was measured Et activity (EA) using the endotoxin activity assay at 1 or 2 d before LT, and then on 1, 5, 7, 14, and 21 postoperative days.


RESULTS
Patients with infections had significantly higher EA levels compared with those without complications before LDLT and 14 postoperative days (P = 0.038 and 0.027, respectively). The average EA level of patients with infections and without complications before LT was 0.22 and 0.08, respectively (P = 0.038). Patients with an EA level higher than 0.20 before LDLT had a significantly longer period of hospitalization compared with those without complications (P = 0.038).


CONCLUSIONS
A preoperative EA level more than 0.20 is a high risk factor for post-transplant infection and a prolonged period of hospitalization.
Department of Transplant Surgery, Jichi Medical University, Shimotsuke City, Tochigi, Japan. yuki371@jichi.ac.jp
Yukihiro
Y
Sanada
Koichi
K
Mizuta
Taizen
T
Urahashi
Yoshiyuki
Y
Ihara
Taiichi
T
Wakiya
Noriki
N
Okada
Naoya
N
Yamada
Kentaro
K
Ushijima
Shinya
S
Otomo
Koichi
K
Sakamoto
Yoshikazu
Y
Yasuda
Hideo
H
Kawarasaki
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004731:Endotoxins / Q000097:blood*; D005260:Female; D006801:Humans; D007223:Infant; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male
D004731:Endotoxins