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Serum bile acid monitoring as an early indicator of allograft function in canine orthotopic liver transplantation.

This study was undertaken to elucidate the correlation between early graft function and serum bile acids profile in canine orthotopic liver transplantation (OLT). The recipient dogs were categorized into four groups: group A (n = 5); bile output over 10 ml during initial 6 hours, group B (n = 4); bile output less than 1 ml during the same period, group C (n = 5); transplanted immediately after graft harvesting, and group D (n = 5); transplanted after 7-hour ice-cold preservation in lactated Ringer's solution. In all cases serum total bile acid (TBA) was markedly elevated during anhepatic phase, the value being 49.4 +/- 48.5 mumol/L. However, in group A, TBA decreased promptly after revascularization, the value at 4-hour being 14.7 +/- 12.7 mumol/L. In contrast, the corresponding TBA level in group B was 62.3 +/- 27.5 mumol/L 4 hours later (p < 0.01 vs group A). In group C, TBA also decreased immediately after reperfusion. Furthermore, in comparison between groups C and D, TBA level was significantly different 4 and 6 hours after reperfusion (p < 0.01). In the reduction rate of TBA (value at each time point after reperfusion the value immediately before reperfusion), the significant difference was observed after 2 hours between groups A and B (p < 0.05). In addition, significant difference was recognized at 30 minutes between groups C and D (p < 0.05). Although the changes of most bile acid fractions were proportional to the changes of TBA in all four groups, the detection of lithocolic acid at 6 hours was characteristic of both groups B and D. In conclusion, there was strong correlation between the TBA level and the graft function during early postoperative period. Therefore, TBA will be a specific and early indicator to differentiate the quality of the transplanted grafts in OLT.

Animals

Retrospective comparative study on the influence of preservation solutions on human renal allograft function and survival.

This retrospective study has revealed that human cadaveric renal grafts preserved with hypertonic citrate solution have a significantly higher proportion with primary graft function compared with EuroCollins preserved grafts. Furthermore, Hypertonic citrate-preserved grafts have better early renal function. Those grafts with primary function show an improved graft survival at 12 months when compared with those grafts which had delayed function. There was no difference in renal graft function at 6 months following transplantation between the hypertonic citrate and EuroCollins-preserved grafts nor in the graft losses from rejection. Although the overall graft failure rate in the hypertonic citrate group is higher, this is due to patient mortality and not to rejection.

Adult