Predicting the viability of grafted livers in rats through a rapid and sensitive metabolic indicator assessed by 31P-NMR spectroscopy |
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Authors: | Meng Yang Hiroshi Shimada Taizo Kobayashi Shuichi Niimoto Gizo Nakagawara |
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Affiliation: | (1) First Department of Surgery, Fukui Medical School, 23-3 Shimoaizuki, Matsuoka-cho, Yoshida-gun, 910-11 Fukui, Japan;(2) Second Department of Surgery, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa, 236 Yokohama, Japan |
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Abstract: | The present study was undertaken to clarify whether a correlation exists between the hepatic ratio of the -phosphorous moiety of ATP (-ATP) to inorganic phosphate (Pi), measured by 31P nuclear magnetic resonance spectroscopy 1 h after the reestablishment of portal blood flow, and the survival rate of rats following liver transplantation. This ratio was compared with the arterial ketone body ratio [AKBR (acetoacetate/3-hydroxybutyrate)], which is accepted as a reliable indicator of liver viability. After the transplantation of fresh livers, the 1-week survival rate was 92% and the -ATP/Pi ratio was 64% of the normal level. When the liver grafts were subjected to warm ischemia for 25 min or 45 min prior to harvesting, the 1-week survival rate decreased to 43% and 0%, respectively, and the -ATP/Pi ratio dropped to 31% and 18% of the normal level, respectively. On the other hand, the AKBR was about 25% of the normal level after transplantation of fresh livers, while it was 37% and 48% after transplantation with 25 min and 45 min of warm ischemia, respectively. However, 4h after the reestablishment of portal blood flow, the AKBR correlated with the -ATP/Pi ratio in both the fresh graft group and the 45-min warm ischemic damage group. These results show that the -ATP/Pi ratio provides an accurate evaluation of a graft viability even at an extremely early stage following liver transplantation, and should prove useful for the early diagnosis of primary graft nonfunction after liver transplantation. |
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Keywords: | liver transplantation ischemia viability NMR |
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