Effect of prostaglandin E1 on preservation injury of canine liver grafts preserved in UW solution

This study investigated whether prostaglandin E₁ (PGE₁) could reduce hepatic injury to the liver graft caused by harvesting and 24-h preservation in University of Wisconsin (UW) solution in a canine model. The PGE₁-treated group was intravenously administered 0.5 g/kg per minute of PGE₁ for 30 min before harvesting, as well as a concentration of 1 mg/l PGE₁ in the washout and UW solutions. In both the PGE₁-treated and the control group, all recipients survived for 1 week or more after transplantation. Arterial ketone body ratio (AKBR) remained over 1.0 in the early postoperative period. The PGE₁ group showed significant reductions in guanase, GOT, and LDH during the early postoperative period compared to the untreated control group. Histological examination disclosed partial mitochondrial swelling, hepatocyte vacuolation, and necrosis in the control group, while such abnormalities were rarely seen in the PGE₁ group. These results suggest that PGE₁ can effectively reduce hepatic injury to liver grafts preserved in UW solution prior to transplantation.     

The superiority of UW solution for maintaining ATP concentrations during pulmonary preservation

We evaluated three solutions used for preserving lungs, namely, University of Wisconsin (UW), Euro-Collins (E-C), and low potassium dextran (LPD), by measuring the high energy phosphates in the preserved lung tissue. The left lungs of Sprague-Dawley rats were excised and flushed with 5 ml of one of the solutions at 10°C through the pulmonary artery, after which they were deflated and immersed in the solution at 10°C for 24 h. The tissue adenosine triphosphate (ATP) concentration in mol/g tissue wet weight after 24 h of storage was 2.55 ± 0.48 (n = 7) in the UW lungs, 1.98 ± 0.25 (n = 6) in the E-C lungs, and 1.53 ± 0.32 (n = 4) in the LPD lungs, being significantly higher in the UW lungs than in either the E-C or LPD lungs (P < 0.05). The histopathological findings of the E-C lungs were more deteriorated, with marked interstitial edema, septal hypertrophy, and perivascular hyaline degeneration, than either the UW or LPD lungs. Thus, the findings of this study indicate the superiority of UW solution for lung preservation.     

UW液用于大鼠离断肢体灌注保存的实验研究

目的：探讨用 UW液灌注离体断肢以延长其活性的效果。方法：选择雄性健康成年 Wistar大鼠20只,体重300～400 g,手术离断双下肢。实验分两部分。实验一：随机选择10只大鼠,再随机分为灌注组（4℃下采用 UW液自股动脉灌注离断肢体直至灌出液清亮为止）和对照组（不予灌注直接冰箱保存）,每组5只。两组均置于4℃冰箱内低温保存24 h,肢体离断后每间隔6 h取离断肢体肌肉组织行病理学观察。实验二：另10只大鼠随机分为连续灌注组（4℃下以12 ml/h的速度持续灌注 UW液24 h）和间断灌注组（4℃下于肢体离断后4、8、12、16、20和24 h以12 ml/h的速度分别灌注 UW液20 min）,每组5只。离断肢体在4℃冰箱内保存灌注24 h,收集离断后4、8、12、16、20和24 h 的灌注流出液,检测碱性磷酸酶（ALP）、丙氨酸转氨酶（ALT）、葡萄糖（GLU）含量,同时在离体12 h、24 h取肌肉组织标本,行 HE 染色观察组织结构变化,透射电镜观察其细胞超微结构的变化。结果：实验一：在各相同时间点,灌注组较对照组肌纤维水肿程度轻,断裂少,细胞较少发生横纹溶解。实验二：连续灌注组与间断灌注组比较,肌纤维均轻度水肿,细胞出现横纹溶解,线粒体肿胀,发生破裂及空泡化现象,两组病理及超微结构改变程度相似,各时间点两组之间 ALP、ALT、GLU 差异无显著性（P＞0.05）。结论：使用 UW液对离断肢体进行灌注后低温保存效果更好。UW液24 h 间断灌注与24 h 连续灌注两种方法对离断肢体的保护效果相当。     

Obstetric aspects of the use in pregnancy-associated hypertension of the beta-adrenoceptor antagonist atenolol

The obstetric implications of the use of the beta-adrenoceptor antagonist atenolol have been evaluated in a prospective, randomized, double-blind, and placebo-controlled study involving 120 women with pregnancy-associated hypertension. The clinical interpretation of antenatal and intrapartum cardiotocographs was uninfluenced by atenolol. Human placental lactogen concentration fell in the atenolol group, but this was not an indicator of subsequent fetal distress. Other obstetric indices, such as urinary estriol excretion, were the same in both groups. Spontaneous premature labor occurred in five women receiving placebo but in none who received atenolol. Together with previously reported findings on pregnancy outcome, our study leads us to conclude that beta-blockers such as atenolol can appropriately be used in the management of hypertension during pregnancy.     

Standardized phase angle indicates nutritional status in hospitalized preoperative patients

There is currently no criterion standard to assess nutritional status, and different methods have been used in hospitalized patients. The aim of this study was to investigate the agreement and the association between bioelectrical impedance analysis derived by standardized phase angle (SPA) and other methods used for the nutritional assessment of body composition, metabolic status, and functional status in surgical patients. The hypothesis was that the SPA is effective for evaluating nutritional status in surgical patients; therefore, it could be used when the application of other assessment methods is not possible. The sample consisted of 125 patients (20-94 years of age) before elective gastrointestinal or hernia repair. The participants were from the Surgical Clinic 1 at the University Hospital of the Federal University of Santa Catarina, Florianópolis, SC, Brazil. Nutritional status was evaluated during the preoperative period based on the triceps skinfold thickness, mid-arm circumference, body mass index, percent weight loss, nutritional risk screening 2002 (NRS 2002), subjective global assessment (SGA), and SPA. The agreement between the SPA and the other methods was assessed with the k coefficient. The agreement between the SPA and the methods of nutritional assessment that were investigated for diagnosing malnutrition was moderate for NRS 2002 and SGA, weak for percent weight loss, and poor for triceps skinfold thickness, mid-arm circumference, and body mass index. There was a significant association between SPA and both NRS 2002 and SGA (P < .001). Our results suggest that SPA is able to indicate the risk of nutritional deficiency in the patients assessed. However, good agreement between SPA and the methods investigated was not observed.     

Adenosine 5＇triphosphate transport and accumulation during the cold preservation of rat hepatocytes in University of Wisconsin solution

AIM: We used isolated hepatocytes to investigate how different concentrations of ATP in the University of Wisconsin (UW) solution affected both cellular ATP content and cell viability during the cold storage and the rewarming step. The mechanism involved in ATP transport and accumulation in hypothermia was also determined. METHODS: The cells were preserved up to 72 h in different conditions: UW solution without ATP (a-group), UW+5 mmol/L ATP (b-group), and UW+10 mmol/L ATP (c-group). The ATP content and the cell viability (LDH release) were determined during the cold storage and the rewarming step. In the groups a and c, the respiratory function of the cells at rewarming was studied. In addition, the cell volume of hepatocytes and the mechanism involved in ATP transport and accumulation were assessed. The extracellular degradation of exogenous nucleotides during transport experiments was investigated by a HPLC technique. RESULTS: After three days of cold storage a loss of cellular ATP content was observed in hepatocytes preserved either without nucleotides (a-group) or with 5 mmol/L ATP (b-group). In contrast, 10 mmol/L ATP (c-group) was able to maintain a normal ATP cellular content, with only a 6% diminution after 72 h of cold storage. The respiratory function was significantly different in hepatocytes preserved with 10 mmol/L ATP than without ATP. No significant change was detected For the three groups in cellular volume during the cold storage. We also report that the time course accumulation of [3H]-ATP by cold stored hepatocytes is a rapid process that is completed after 180 s with linear dependence on the extracellular ATP concentration (linear fitting results in a slope of 0.5624±0.1179 mmol/L ATP intracell/mmcl/L ATP extracell). CONCLUSION: Our results show that, during hypothermic storage in UW solution, hepatocytes are permeable to ATP by a diffusive mechanism. Also, we found that it is ATP the main extracellular nucleotide available for transport and it is not the breakdown products.     

A report of the eurotransplant randomized multicenter study comparing kidney graft preservation with HTK, UW and EC solutions

Abstract Special attention has been focused in this randomized study on the primary function of renal allografts preserved with different solutions. Histidine-Tryptophane-Ketoglutarate (HTK) and University of Wisconsin (UW) solutions provided a significantly lower incidence of delayed graft function compared to Euro-Collins solution. Improved renal function after transplantation was observed in the HTK and UW groups compared to the EC group.     

The pituitary--adrenal axis in the sea snake, Hydrophis cyanocinctus daudin.

The sea snake Hydrophis cyanocintus was subjected to conventional pharmacological tests of pituitary-adrenal function. Administration of synthetic ACTH resulted in adrenal hypertrophy, enhanced Δ⁵-3β-hydroxysteroid dehydrogenase (3β-OHSD) activity and raised peripheral titres of corticosterone and aldosterone to 300% those of controls. Metopirone treatment resulted in adrenal hyperplasia and enhanced 3β-OHSD activity, but aldosterone titres were unchanged despite a 90% reduction in corticosterone titre. Dexamethasone administration was followed by adrenal atrophy and diminished 3β-OHSD activity. Titres of both corticosteroids were much lowered. Despite such marked variations in adrenal function, no alteration in plasma ion concentrations or total osmolarity could be detected. These and earlier data suggest that separate regulatory mechanisms for corticosterone and aldosterone may exist in the sea snake, and such a differential regulation may be of physiological importance.     

Accumulation of Crystal Deposits in Abdominal Organs Following Perfusion with Defrosted University of Wisconsin Solutions

Previous studies reported on both visible and invisible particles in University of Wisconsin (UW) solutions. Those particles originated from components of the bags. In recent clinical observations we noticed macroscopically visible, indissoluble particles in UW bags reaching subzero temperatures during transportation of organs and preservation solutions. In an experimental model we examined whether those particles could be detected following perfusion of abdominal organs with established perfusion solutions. UW-, HTK- or physiological saline solutions reached -3 +/- 0.5 degrees C under conditions frequently applied during transportation. UW solutions demonstrated the accumulation of visible, indissoluble crystals and were subsequently used for the perfusion of abdominal organs in LEW rats. After perfusion with UW solutions stored at freezing temperatures, crystals were detected in all abdominal organs localized in and around vessels, bile ducts, glomeruli and in the interstitium of harvested livers, kidneys and pancreas. By spectroscopy, we were able to characterize crystals as adenosine. A 40-microm pore-size filter eliminated crystals from UW solutions. Crystals were absent in organs perfused with HTK- or saline solutions kept at subzero conditions. UW solutions can reach subzero temperatures under commonly used transportation conditions. Under these conditions, visible crystals accumulate and can be detected in abdominal organs of an experimental system.