Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:2.6.1.2 (alanine aminotransferase)
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The effect of nutritional status on livers preserved either by simple cold storage or by hypothermic perfusion was studied using isolated rat liver perfusion model. Livers either form fed or fasted rats were preserved for 18 hours by simple cold storage procedure with UW solution, or continuously perfused for 12 hours at 5 or 20 degrees C. Each liver was assessed by one hour normothermic reperfusion following preservation period. Fasted livers in each preservation procedure demonstrated deterioration of hepatocytes more than fed livers assessed by AST, ALT and LDH liberation into perfusate. PNP in the perfusion procedures showed no difference between fasted and fed livers. Slight sinusoidal lining cells changes and vacuolization in hepatocytes were preferential in all groups. Patchy areas of hepatocytic discoloration were often seen in fasted group in each preservation procedure. The nutritional status of hepatic graft is important in both simple storage and continuous perfusion preservation method.
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PMID:Effect of nutritional status on hypothermic liver perfusion. 803 Dec 16

Need of oxygen by the liver during hypothermic perfusion was evaluated using isolated perfusion model. Livers were perfused by a continuous perfusion system with oxygen saturated perfusate or nitrogen saturated perfusate, or simply stored for 12 hours at 5 degrees C. Quality of individual liver was assessed at one hour after normothermic reperfusion. Tissue edema was significant in all experimental groups, but the extent of which was much higher in nitrogen and simple cold storage groups. AST, ALT, LDH and PNP in the perfusate at the end of normothermic reperfusion were significantly higher in nitrogen and simple storage groups and those of oxygen group were similar to the control. Tissue adenine nucleotide and purine catabolite concentration in oxygen group was almost identical to the control at the end of hypothermic preservation, while ATP and energy charge in nitrogen and simple cold storage groups were significantly low. Conjugated dienes before and after reperfusion showed no difference in any groups, indicating no involvement of free radical injury on reperfusion in this asanguineous perfusion model. These results suggest that continuous supply of oxygen is necessary for liver preservation even though the temperature is lowered to inhibit cellular metabolism.
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PMID:Evaluation of oxygen necessity during hypothermic liver perfusion. 803 Dec 17

The early outcome of 201 liver grafts transplanted consecutively between September 1988 and November 1991 was investigated retrospectively. Donors were categorized according to their hospitalization periods in an intensive care unit (ICU) prior to harvesting, their causes of death, and the variables generally believed to be critical in liver donation, such as arterial hypotension (n = 69; 34.3%), cardiopulmonary resuscitation (n = 20; 9.9%), elevated serum-aminotransferases (s-AT) (n = 11; 5.5%), or an age over 50 years (n = 16; 8.0%). Ninety-one donors (45.3%) spent less than 24 h in an ICU; 29 donors (14.4%) and 14 donors (7.0%) had hospitalization periods generally considered critical of 4-6 days and more than 6 days, respectively. The most common causes of death were subarachnoidal bleeding (n = 70; 34.8%), isolated head injuries (n = 68; 33.8%), and polytraumata (n = 33; 16.4%). The postischemic hepatocellular damage was evaluated comparing peak post-transplant s-AT, which did not differ significantly between groups; nor did donor and recipient ages or cold ischemia times. Fourteen grafts (7.0%) showed a reversible preservation injury presenting with post-transplant s-AT elevated above 2000 IU/l. Five cases (2.5%) of a primary non-functioning graft (PNF) underwent early retransplantation successfully. Serum-aminotransferases (AST: 4944 +/- 2280 IU/l; ATL: 3186 +/- 1918 IU/l) were significantly (P < 0.01) elevated as compared to primary functioning grafts (AST: 699 +/- 935 IU/l; ALT: 620 +/- 701 IU/l). The donor structure of both groups reflected the distribution of variables in the entire collective. No significant overrepresentations were observed.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Donor criteria in hepatic transplantation. 814 13

Liver allografts are traditionally rinsed with cold lactated Ringer's (LR) prereperfusion to clear K(+)-rich preservation solution from the hepatic vasculature. LR has been shown, however, to be injurious to the graft. By restoring portal blood flow without rinsing and discarding the initial blood traversing the liver (PB flush), we sought to eliminate rinsing without inducing hyperkalemia. Between August 1988 and December 1992, 481 OLTx were performed in 412 pts. Four rinsing methods were used sequentially: group 1 (157 pts)--low-flow-rate cold LR rinse (500 ml, 100 ml/min via standard i.v. tubing at 100 cm H2O [LFLR]) during lower caval anastomosis; Group 2 (120 pts)--LFLR as in group 1, at reperfusion, 500 ml PB flush via IVC catheter; group 3 (66 pts)--high-flow-rate LR rinse (500 ml, 1 L/min using large-bore tubing with 100 cm H2O rinsing pressure [HFLR]), PB flush as in group 2; Group 4 (62 pts)--no LR rinse; PB flush as in groups 2 and 3. Poor early graft function (PEGF) was defined as peak ALT or AST > 2500 U or PT > 16 sec (on POD 2); PEGF causing re-OLTx or death within 14 days was called primary nonfunction (PNF). Group 1 and Group 3 had high PEGF rates. Group 4 had significantly less PEGF than Group 1, with a trend toward a significant difference from Group 3. In Group 1, 3 pts. had intraoperative hyperkalemic cardiac arrest; this did not occur when PB flush was performed. PB flush without prior rinsing optimizes graft function without risk of hyperkalemia. LR rinse, alone or followed by PB flush, is unnecessary and may be deleterious.
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PMID:Obviation of prereperfusion rinsing and decrease in preservation/reperfusion injury in liver transplantation by portal blood flushing. 815 23

Glycine has been shown to protect renal tubule cells and hepatocytes from ischemia, ATP depletion, and cold storage injury. Glycine may be a useful additive to organ preservation solutions or suppress reperfusion injury by infusion into recipients of liver transplantation. In this study, the effects of glycine on survival and postoperative liver injury were studied in the rat and dog orthotopic transplant model. Rat livers preserved for 30 hr in the University of Wisconsin (UW) solution were 50% viable (3 of 6 survivors for 7 days). When glutathione was replaced by 10 mM glycine, survival increased to 100% (6 of 6). There was a significant reduction in hepatocellular injury at the end of preservation (lactate dehydrogenase [LDH] in the pretransplant flush-out of the liver was lower in the glycine group) and after transplantation (serum LDH concentration 6 hr after transplant was lower in the glycine group). In the dog, omission of glutathione from the UW solution resulted in 33% survival (48-hr preservation model) versus 100% survival with glutathione. Replacing glutathione in the UW solution by glycine did not improve survival (33% after 48 hr of preservation). However, when glycine was given to recipients of livers preserved in the UW solution for 24 or 48 hr, there was a decrease in the degree of hepatocellular injury. After 48 hr of preservation, peak aspartate aminotransferase, alanine aminotransferase, and LDH were reduced by about 45-55% when glycine was given to the recipient. Although the differences, with and without glycine treatment of the recipients, did not reach statistical significance, there was a noticeable reduction in hepatocellular injury with glycine. There was 100% survival of dogs in the groups that received livers preserved with the UW solution plus or minus glycine infusion. Hepatamine, a parenteral nutrition solution containing glycine and other amino acids increased hepatocellular injury (higher concentrations of aspartate aminotransferase, alanine transferase, and LDH versus control 48-hr preserved livers), although all dogs survived. This study shows that glycine is cytoprotective when administered to recipients of livers preserved for 24 or 48 hr and suppresses hepatocellular injury, as reflected in a reduction in the concentration of serum enzymes. However, the differences, with and without glycine, were, at best, marginal and further studies are needed to determine whether glycine would make a significant improvement in liver preservation and prevent primary nonfunction.
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PMID:Effect of glycine in dog and rat liver transplantation. 821 99

When examining diseased calves, sporadically pronounced haemoglobinuria with dark red urine can be observed. In serious cases the clinical picture may be manifold but peculiar; in easy cases, however, when there are no distinct clinical symptoms, a larger scale of examinations is needed to aid differential diagnosis. Eight roughage-fed bulls aged two months, weighing 55-71 kg were used in this experiment. Selected biochemical indices of the mineral, enzymatic, hepatic, energetic and urinary profile were determined in the blood serum and urine of the animals. After the administration of cold water at an amount representing 12% of the animal's body weight, ionogram values were determined. In all indices a positive correlation with hydraemia and a decrease in Na, Cl, Ca, Mg and P levels were observed. Correction of the above levels occurred within 24 hours, with the exception of Na and P concentrations that did not reach starting values. As to the enzymatic profile (AST, ALT, GGT), no pronounced disturbances could be observed. The most profound changes were seen in AST activity that increased in the 5th hour of the experiment. A slight tendency towards hypoproteinaemia was observed to continue even in 24 hours. Hypoglobulinaemia reached its starting value in the 24th hour while simultaneously albumin levels slightly increased. The increasing bilirubin levels reached their maximum in the 5th and 6th hour; correction of the former occurred within 24 hours. The urinary profile revealed polyuria, aciduria, aquaeous urine and haemoglobinuria, the latter reaching its peak between hours 1 and 3 following water administration.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Experimental paroxysmal hemoglobinuria in calves and selected biochemical indicators in the blood and urine]. 823 29

Liver function was measured after 20 hr of hypothermic preservation in University of Wisconsin (UW) solution and in modified UW (MUW) solution containing gamma-hydroxybutyrate (GHB). Rat livers were rapidly cooled by in situ portal flushing with chilled UW or MUW solution, then removed and stored at 4 degrees C. After 20 hr of storage, liver hemodynamics and function were studied during 90 min of reperfusion in an isolated perfused liver system. Three groups were investigated: livers flushed with and stored in a commercial UW solution for 20 hr (UW group) or in a modified UW solution with 500 mg/L of GHB added (MUW group), and livers flushed with UW solution and reperfused immediately thereafter (control group). Addition of GHB to the cold storage solution significantly improved liver function after 20 hr of cold storage. Livers in the MUW group produced bile at a much higher rate then those in UW group (3.47 +/- 0.34 vs. 0.87 +/- 0.29 ml/100 g liver weight/min at 60 min of reperfusion), while the control livers produced 4.60 +/- 0.40 ml bile/100 g liver weight/min. At the same time, liver blood flow at a perfusion pressure of 11 cm H2O was significantly higher in the MUW group than in the UW group (391 +/- 32 ml/min/100 g liver vs. 177 +/- 33 ml/min/100 g liver) and only slightly lower than in the control group (494 +/- 49 ml/min/100 g liver). Aspartate amino-transferase (AST) and alanine aminotransferase (ALT) levels in perfusate samples taken from the venous effluent were raised during reperfusion in all groups. However, AST and ALT values were significantly lower (503 +/- 88 IU/L/100 g AST, 184 +/- 33 IU/L/100 g ALT) at 90 min of reperfusion in the MUW group than in the UW group (1567 +/- 330 IU/L/100 g for AST and 644 +/- 227 IU/L/100 g for ALT). This study clearly demonstrates that GHB greatly improves liver function and integrity after hypothermic preservation and has the potential to substantially increase the acceptable storage time of donor livers before transplantation.
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PMID:gamma-Hydroxybutyrate mediated protection of liver function after long-term hypothermic storage. 829 Nov 18

Lipid peroxidation may play a major role in the loss of liver graft viability after prolonged cold ischemia and reperfusion injury. The lazaroid compound U74006F is a potent inhibitor of lipid peroxidation, and this study was designed to evaluate the efficacy of this compound in preventing cold ischemia-reperfusion damage in three different models: pig endothelial cells in culture, ex vivo isolated pig liver perfusion and orthotopic transplantation of syngeneic rat livers. The addition of U74006F to University of Wisconsin preservation solution significantly prolonged endothelial cell viability after 48 and 72 hr of cold ischemia and reoxygenation (p < 0.01). Donor pigs were injected with vehicle or U74006F (4.5 mg/kg) before liver harvest. After 24 hr of cold storage in University of Wisconsin solution, the livers were perfused with pig blood for 180 min in an isolation chamber. Measurements of liver function parameters, including AST, ALT, bile production, superoxide anion and phospholipase A2 release, were assessed every 60 min. Although bile production was similar in the U74006F-treated and control groups, significant decreases of AST and ALT levels (p < 0.01) in the perfusate of the livers from treated donors were observed. In addition, the U74006F group displayed significantly reduced release of superoxide anion and phospholipase A2 compared with these parameters in the untreated group (p < 0.05 and p < 0.01, respectively). In the last model, donor rats were treated with U74006F before harvest; the rat liver grafts were preserved in cold University of Wisconsin solution for 24 hr and then transplanted into recipient rats.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Protective effect of the lazaroid U74006F in cold ischemia-reperfusion injury of the liver. 829 99

Orthotopic liver transplantation has become the accepted treatment for end-stage liver disease in children. To evaluate the efficacy of the University of Wisconsin (UW) preservation solution in pediatric liver transplantation, a group of 34 livers preserved with UW solution was compared in a nonrandomized fashion with a historical control group of 34 livers preserved with Euro Collins (EC) solution. Primary graft nonfunction did not occur in either group. Both groups were similar with respect to age, sex, weight, diagnosis, severity of the recipient's condition, donor condition at harvest, donor/recipient blood type match, and immunosuppressive management. The UW group had a significantly higher bilirubin, AST, ALT, and GGT during the first week after transplantation when compared with the EC group but no significant differences were noted after the ninth post-transplant day. No differences were noted when the groups were compared as to surgery time (9.1 v 8.4 hours), blood volumes replaced (1.8 v 2.0), number of ICU days (5.0 v 6.5), total number of infections per graft (1.0 v 0.8), total hospital days (31 v 30), and hospital cost ($134,000 v $126,000). The total preservation time was improved from 7 hours (range, 3.2 to 9.9) in the EC group to 13.9 hours (range, 6.9 to 22.3) in the UW group (P < .001). UW solution allows a significant increase in cold ischemic time in liver transplantation when compared with EC. This increase in preservation time resulted in no detrimental effect when compared with EC and potentially led to milder episodes of rejection in the postoperative period.
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PMID:University of Wisconsin preservation solution compared with Euro Collins preservation solution in pediatric liver transplantation. 834 Aug 64

Between September 1988 and November 1991, 201 donor hepatectomies and transplantations were performed. Fifty-four livers (26.9%) were harvested by other teams and shipped for transplantation; 147 livers (73.1%) were procured by teams from our transplant center. Comparing the maximal postoperative serum-aminotransferases (s-AT), we evaluated the postischemic damage of shipped organs (AST 951 +/- 931 IU/l; ALT 820 +/- 666 IU/l) and nonshipped organs (AST 753 +/- 1256 IU/l; ALT 636 +/- 896 IU/l); this did not differ significantly. Donor-related factors, such as critical parameters (i.e., cardiac arrest, arterial hypotension, age over 50 years, or elevated preoperative s-AT), length of stay in the intensive care unit before harvesting, and cause of death showed similar patterns in both groups. The mean cold ischemia time in the group of shipped livers (12 h 10 min +/- 4 h 22 min) and in the nonshipped livers (10 h 6 min +/- 3 h 53 min) did not differ significantly. Five cases (2.5%) of a primary non-functioning graft presenting with significantly (P < 0.001) elevated s-AT (AST 4944 +/- 2280 IU/l; ALT 3186 +/- 1918 IU/l) necessitated an early retransplantation. One organ was shipped and four organs were nonshipped, thus corresponding to their portion of all grafts. These data indicate that the transplantation of shipped livers is a safe procedure procedure, provided that procurement is done by experienced centers.
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PMID:Transplantation of shipped donor livers. 834 65


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