title: Isoflurane does not protect from brain death-associated aggravation of cold hepatic ischemia-reperfusion injury.
abstract: BACKGROUND
  Previous studies have shown that brain death aggravates cold ischemia-reperfusion injury in liver transplantation. Isoflurane, a volatile anesthetic, has been indicated to reduce warm hepatic ischemia-reperfusion injury. Herein, we studied in Sprague-Dawley rats whether isoflurane is capable of ameliorating brain death-associated aggravation of cold hepatic ischemia-reperfusion injury.
  
  
  METHODS
  Brain-dead animals were treated for 30 min with isoflurane (MAC 1.5%; n=8). Animals without isoflurane treatment served as controls (n=8). Another 13 animals without induction of brain death served as sham controls. After a 4-h period portal venous blood perfusion, hepatic microcirculation and bile flow were determined. Livers were recovered and stored for 24 h in 4°C cold HTK solution, followed by reperfusion with 37°C Krebs-Henseleit-buffer for 60 min. Liver enzymes in the effluent and bile flow were analyzed. Hepatocellular morphology was determined by histology and immunohistochemistry.
  
  
  RESULTS
  Brain death reduced portal venous blood perfusion and bile flow, induced heme oxygenase-1 (HO-1), and resulted in hepatocellular damage. Isoflurane treatment did not prevent the reduction of portal venous blood perfusion or bile flow or the induction of HO-1. Accordingly, isoflurane was not capable of reducing the hepatocellular injury.
  
  
  CONCLUSIONS
  Isoflurane does not protect from brain death-associated aggravation of cold hepatic ischemia-reperfusion injury.
authors.affiliation: Department of General, Visceral and Transplant Surgery, University of Heidelberg, Heidelberg, Germany.
authors.forename: Moritz J
authors.initials: MJ
authors.lastname: Strowitzki
authors.affiliation: Department of General, Vascular and Pediatric Surgery, Saarland University Hospital, Homburg, Germany.
authors.forename: Mohammed R
authors.initials: MR
authors.lastname: Moussavian
authors.affiliation: Department of General, Visceral and Transplant Surgery, University of Heidelberg, Heidelberg, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Keppler
authors.affiliation: Klinik St. Anna, Ärztehaus Lützelmatt, Luzern, Switzerland.
authors.forename: Martin K
authors.initials: MK
authors.lastname: Schilling
authors.affiliation: Institute for Clinical & Experimental Surgery, Saarland University, Saarbrücken, Germany.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Menger
authors.affiliation: Department of General, Vascular and Pediatric Surgery, Saarland University Hospital, Homburg, Germany.
authors.forename: Maximilian
authors.initials: M
authors.lastname: von Heesen
mesh_terms: D000818:Animals; D001926:Brain Death / Q000473:pathology; D006801:Humans; D007530:Isoflurane / Q000627:therapeutic use*; D008099:Liver / Q000098:blood supply* / Q000473:pathology; D051381:Rats; D017207:Rats, Sprague-Dawley; D015427:Reperfusion Injury / Q000517:prevention & control*
chemical_list: D007530:Isoflurane