Hypoxia inducible factor-1alpha accumulation in steatotic liver preservation: role of nitric oxide.
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AIM: To examine the relevance of hypoxia inducible factor (HIF-1) and nitric oxide (NO) on the preservation of fatty liver against cold ischemia-reperfusion injury (IRI). METHODS: We used an isolated perfused rat liver model and we evaluated HIF-1alpha in steatotic and non-steatotic livers preserved for 24 h at 4 degrees C in University of Wisconsin and IGL-1 solutions, and then subjected to 2 h of normothermic reperfusion. After normoxic reperfusion, liver enzymes, bile production, bromosulfophthalein clearance, as well as HIF-1alpha and NO [endothelial NO synthase (eNOS) activity and nitrites/nitrates] were also measured. Other factors associated with the higher susceptibility of steatotic livers to IRI, such as mitochondrial damage and vascular resistance were evaluated. RESULTS: A significant increase in HIF-1alpha was found in steatotic and non-steatotic livers preserved in IGL-1 after cold storage. Livers preserved in IGL-1 showed a significant attenuation of liver injury and improvement in liver function parameters. These benefits were enhanced by the addition of trimetazidine (an anti-ischemic drug), which induces NO and eNOS activation, to IGL-1 solution. In normoxic reperfusion, the presence of NO favors HIF-1alpha accumulation, promoting also the activation of other cytoprotective genes, such as heme-oxygenase-1. CONCLUSION: We found evidence for the role of the HIF-1alpha/NO system in fatty liver preservation, especially when IGL-1 solution is used. (+info)
One-suture, 1-knot technique in renal vascular transplant.
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OBJECTIVES: We describe the results of our 1-suture, 1-knot technique for vascular anastomosis in renal transplant. This technique can be used for both of the arterial and venous anastomoses. MATERIALS AND METHODS: Between May 2006 and June 2008, a total of 386 renal transplants were done in our center, using a 1-suture, 1-knot technique. Intraoperative data including the warm and cold ischemic time, arterial and venous anastomotic time, and any early and late postoperative complications in the follow-up were recorded. RESULTS: Mean age of recipients was 37 years. Mean kidney warm and cold ischemia time was 4.8 and 26.2 minutes. Mean arterial and venous anastomotic time was 5.1 and 7.2 minutes. No vascular complications were seen in the early postoperative period. Delayed graft function was diagnosed in 36 patients, but a renal scan showed good perfusion of the allografts of these cases. In the mean follow-up of 18.5 months, we did not encounter any case of renal artery thrombosis or any suspected arterial stenosis. CONCLUSIONS: The 1-suture, 1-knot technique is a safe, rapid, and easy method for arterial and venous anastomosis of the renal allograft with low complication rates. It is especially valuable in obese patients and recipients with deep iliac fossa. (+info)
A comparative study on suture versus cuff anastomosis in mouse cervical cardiac transplant.
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OBJECTIVES: To compare the cuff technique to traditional suture technique in establishing cervical heart transplant model in mice. MATERIALS AND METHODS: Eighty transplants were performed by 1 surgeon, 40 using the cuff technique, and 40 using the suture technique, under the same circumstances. RESULTS: The cuff approach was significantly superior to conventional suture anastomosis in higher surgical successful rate, less surgery, and less ischemic time (P < .05). Suture anastomosis required an intensive microsurgical training and at least a 16x surgical microscope, while the cuff anastomosis required less learning time and a 10x surgical microscope. CONCLUSIONS: The cuff technique is the preferred method in cervical heart transplant model in mice. (+info)
Improved rat steatotic and nonsteatotic liver preservation by the addition of epidermal growth factor and insulin-like growth factor-I to University of Wisconsin solution.
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Impact of delayed graft function on renal function and graft survival in deceased kidney transplantation.
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OBJECTIVES: To define the risk factors for delayed graft function and study the impact of such delays on renal function and long-term allograft survival in renal transplant recipients. DESIGN: Single-centre retrospective study. SETTING: Regional hospital, Hong Kong. PATIENTS: Records of 118 Chinese renal transplant recipients from 1 July 1997 to 31 July 2005 were reviewed, and categorised into delayed and immediate graft function groups. RESULTS: Delayed graft function was observed in about 19% of patients, for which cold ischaemic time was an important independent predictor. For each additional hour of cold ischaemic time, the odds ratio increased for delayed function by 0.002 (95% confidence interval, 0.001-0.003; P=0.03). Multivariate analysis revealed that neither cold ischaemic time nor delayed graft function was associated with acute rejection. On the other hand, at 1 year both delayed graft function (odds ratio=18.5; 95% confidence interval, 2.6-130.5; P=0.003) and donor age (1.2; 1.1-1.3; P=0.003) were related to a glomerular filtration rate of less than 30 mL/min. When renal function between patients with and without delayed graft function during the first 3 years was compared, it was significantly better in those without delayed graft function. However, there was no significant difference in death-censored graft survival between delayed graft function and immediate graft function groups. CONCLUSIONS: Delayed graft function has a significant adverse effect on graft function at 1 year. Limiting cold ischaemic time is important as it is an independent predictor of delayed graft function. (+info)