title: Metabolic preconditioning with fructose prior to organ recovery attenuates ischemia-reperfusion injury in the isolated perfused rat liver.
abstract: OBJECTIVE
  Ischemia-reperfusion injury is associated with a high rate of primary organ dysfunction and thereby contributes substantially to morbidity and mortality in the course of liver transplantation. In the present study, the impact of metabolic preconditioning with fructose on ischemia-reperfusion injury in the isolated perfused rat liver model is evaluated.
  
  
  METHODS
  Fasted rats received a single intravenous fructose injection to induce metabolic preconditioning (fructose group) or a volume equivalent of normal saline (control group) 10 min before liver explantation. After 26 h of cold storage, livers were reperfused for 90 min at 37°C with Krebs-Henseleit buffer. The parameters used to quantify ischemia-reperfusion injury included hepatic oxygen consumption, enzyme release, and cell viability.
  
  
  RESULTS
  During reperfusion, livers in the fructose group consumed more oxygen than livers in the control group (p < 0.005), indicating ATP synthesis as a result of glycolytic fructose degradation. Moreover, cell injury was reduced by fructose administration, as reflected by a lower enzyme release during both cold ischemia and reperfusion (p < 0.05). Finally, hepatocyte viability at the end of reperfusion was significantly higher in the fructose group (p < 0.01). However, there was no significant difference between the two experimental groups in reference to the viability of endothelial cells.
  
  
  CONCLUSIONS
  In clinical use, metabolic preconditioning with fructose prior to organ recovery might contribute to a reduction in the incidence of primary organ dysfunction after liver transplantation.
authors.affiliation: Institute of Physiology and Pathophysiology, University of Heidelberg, Heidelberg, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Lehne
authors.forename: Rainer
authors.initials: R
authors.lastname: Nobiling
mesh_terms: D000818:Animals; D015415:Biomarkers / Q000378:metabolism; D002470:Cell Survival / Q000187:drug effects; D004334:Drug Administration Schedule; D005260:Female; D005632:Fructose / Q000494:pharmacology / Q000627:therapeutic use*; D007275:Injections, Intravenous; D008099:Liver / Q000187:drug effects / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D016031:Liver Transplantation; D010101:Oxygen Consumption / Q000187:drug effects; D011300:Preoperative Care / Q000379:methods*; D020011:Protective Agents / Q000494:pharmacology / Q000627:therapeutic use*; D051381:Rats; D017207:Rats, Sprague-Dawley; D015427:Reperfusion Injury / Q000517:prevention & control*; D020858:Tissue and Organ Harvesting; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D020011:Protective Agents; D005632:Fructose