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Efficacy of prostaglandin I2 analog on liver grafts subjected to 30 minutes of warm ischemia
Authors:Akihiro Kishida  Yoshimasa Kurumi  Masashi Kodama
Affiliation:(1) First Department of Surgery, Shiga University of Medical Science, Seta Tsukinowa-cho, 520-21 Otsu, Shiga, Japan
Abstract:Due to the fact that no effective conditioning agent for hemodynamically unstable donors exists, the number of suitable donors is limited. The efficacy of OP-41483, a stable analog of prostaglandin I2, as a conditioning agent of the liver was investigated in this study using pigs. OP-41483 was administered via the portal tributary for 10 min before 30 min of warm ischemia. Graft livers were procured after perfusion with OP-41483 in cold normal saline, the flushed with OP-41483 in Euro-Collins solution and placed in cold storage prior to orthotopic transplantation. OP-41483 was also administered intraportally for 120 min after reperfusion. Biochemical and histological studies, and survival rates were compared with a control group not given OP-41483 in an otherwise similar experimental protocol. The graft function recovered better in the OP group than in the control group, shown by the lactate values and lactate-to-pyruvate ratios. The marked congestion noted in the parenchyma of the control group livers was minimal in the OP group, verifying the microcirculatory effect of prostaglandin I2 by its vasodilatory and antithrombotic actions. These findings suggest that OP-41483 has some protective effect as a conditioning agent in liver transplantation, with timing of administration being crucial.
Keywords:prostaglandin  warm ischemia  liver allograft
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