title: Impact of oxygen free radicals in rat partial liver transplantation.
abstract: BACKGROUND
  Due to the shortage of suitable organs, the demand for partial liver transplantation from living donors has increased worldwide. N-acetylcysteine (NAC) has shown protective effects as a free radical scavenger during hypothermic preservation and warm ischemia-reperfusion liver injury; however, no study has reported the effects in partial liver transplantation. The aim of this study was to analyze the impact of NAC on liver graft microcirculation and graft function after partial liver transplantation in rats.
  
  
  METHODS
  Orthotopic partial liver transplantations were performed in 40 rats following cold storage in histidine-tryptophan-ketoglutarate solution for 3 h with 20 mM NAC (NAC group, n = 20) or without (control group, n = 20). We assessed portal circulation, graft microcirculation, and biochemical analyses of plasma at 1, 3, 24, and 168 h after portal reperfusion.
  
  
  RESULTS
  (Control versus NAC, median and range): Portal venous pressure was significantly lower with NAC (P = 0.03). Microcirculation measured by laser Doppler was significantly improved with NAC throughout the time course (P = 0.003). Alanine aminotransferase levels were significantly lower in the NAC group (P < 0.05). Total antioxidative capacity was significantly higher in the NAC group at 1 h after reperfusion (Trolox equivalents: median, 3 μM; range, 2.9-6.7 versus median, 16.45 μM; range, 10.4-18.8). Lipid peroxidation was significantly abrogated in the NAC group (median, 177.6 nmol/mL; range, 75.9-398.1 versus median, 71.5 nmol/mL; range, 58.5-79 at 3 h).
  
  
  CONCLUSIONS
  This study showed that NAC treatment during cold storage resulted in improved microcirculation and preservation quality of partial liver graft likely because of enhanced antioxidant capacity and reduced lipid peroxidation.
authors.affiliation: Institute for Laboratory Animal Science and Experimental Surgery, RWTH-Aachen University, Aachen, Germany.
authors.forename: Pramod Kadaba
authors.initials: PK
authors.lastname: Srinivasan
authors.affiliation: Institute for Laboratory Animal Science and Experimental Surgery, RWTH-Aachen University, Aachen, Germany; Department of Hepatobiliary, Pancreas and Transplant Surgery, Kyoto University, Kyoto, Japan.
authors.forename: Shintaro
authors.initials: S
authors.lastname: Yagi
authors.affiliation: Institute for Laboratory Animal Science and Experimental Surgery, RWTH-Aachen University, Aachen, Germany; Department of Hepatobiliary, Pancreas and Transplant Surgery, Kyoto University, Kyoto, Japan.
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Nagai
authors.affiliation: Division of Pathology, Institute for Laboratory Animal Science and Experimental Surgery, RWTH-Aachen University, Aachen, Germany.
authors.forename: Mamdouh
authors.initials: M
authors.lastname: Afify
authors.affiliation: Department of Hepatobiliary, Pancreas and Transplant Surgery, Kyoto University, Kyoto, Japan.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Hata
authors.affiliation: Department of Hepatobiliary, Pancreas and Transplant Surgery, Kyoto University, Kyoto, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Uemoto
authors.affiliation: Institute for Laboratory Animal Science and Experimental Surgery, RWTH-Aachen University, Aachen, Germany. Electronic address: rtolba@ukaachen.de.
authors.forename: Rene H
authors.initials: RH
authors.lastname: Tolba
mesh_terms: D000111:Acetylcysteine / Q000494:pharmacology; D000818:Animals; D005609:Free Radicals / Q000378:metabolism; D015227:Lipid Peroxidation; D016031:Liver Transplantation; D008297:Male; D008833:Microcirculation; D009926:Organ Preservation; D010100:Oxygen / Q000378:metabolism*; D051381:Rats; D011917:Rats, Inbred Lew
chemical_list: D005609:Free Radicals; D010100:Oxygen; D000111:Acetylcysteine
keywords: HTK; Microcirculation; N-Acetylcysteine; Partial liver transplantation; Warm ischemia