BACKGROUND: Ischaemic preconditioning (IPC) of the right liver graft in the donor has not been studied in adult-to-adult living related liver transplantation (LRLT). OBJECTIVE: To assess the IPC effect of the graft on ischaemia reperfusion injury in the recipient and compare recipient and donor outcomes with and without preconditioned grafts. PATIENTS AND METHODS: Alternate patients were transplanted with right lobe grafts that were (n = 22; Group (Precond)) or were not (n = 22; Group (Control)) subjected to IPC in the living donor. Liver ischaemia-reperfusion injury, liver/kidney function, morbidity/mortality rates and outcomes were compared. Univariate and multivariate analyses were performed to identify factors predictive of the aspartate aminotransferase (AST) peak and minimum prothrombin time. RESULTS: Both groups had similar length of hospital stay, morbidity/mortality, primary non-function and acute rejection rates. Post-operative AST (P = 0.8) and alanine aminotransferase (ALT) peaks (P = 0.6) were similar in both groups (307 +/- 189 and 437 +/- 302 vs. 290 +/- 146 and 496 +/- 343, respectively). In univariate analysis, only pre-operative AST and warm ischemia time (WIT) were significantly associated with post-operative AST peak (in recipients). In multivariate analysis, the graft/recipient weight ratio (P = 0.003) and pre-operative bilirubin concentration (P = 0.004) were significantly predictive of minimum prothrombin time post-transplantation. CONCLUSIONS: Graft IPC in the living related donor is not associated with any benefit for the recipient or the donor and its clinical value remains uncertain.
BACKGROUND: Ischaemic preconditioning (IPC) of the right liver graft in the donor has not been studied in adult-to-adult living related liver transplantation (LRLT). OBJECTIVE: To assess the IPC effect of the graft on ischaemia reperfusion injury in the recipient and compare recipient and donor outcomes with and without preconditioned grafts. PATIENTS AND METHODS: Alternate patients were transplanted with right lobe grafts that were (n = 22; Group (Precond)) or were not (n = 22; Group (Control)) subjected to IPC in the living donor. Liver ischaemia-reperfusion injury, liver/kidney function, morbidity/mortality rates and outcomes were compared. Univariate and multivariate analyses were performed to identify factors predictive of the aspartate aminotransferase (AST) peak and minimum prothrombin time. RESULTS: Both groups had similar length of hospital stay, morbidity/mortality, primary non-function and acute rejection rates. Post-operative AST (P = 0.8) and alanine aminotransferase (ALT) peaks (P = 0.6) were similar in both groups (307 +/- 189 and 437 +/- 302 vs. 290 +/- 146 and 496 +/- 343, respectively). In univariate analysis, only pre-operative AST and warm ischemia time (WIT) were significantly associated with post-operative AST peak (in recipients). In multivariate analysis, the graft/recipient weight ratio (P = 0.003) and pre-operative bilirubin concentration (P = 0.004) were significantly predictive of minimum prothrombin time post-transplantation. CONCLUSIONS: Graft IPC in the living related donor is not associated with any benefit for the recipient or the donor and its clinical value remains uncertain.
Authors: D H Van Thiel; N G Hagler; R R Schade; M L Skolnick; A P Heyl; E Rosenblum; J S Gavaler; R J Penkrot Journal: Gastroenterology Date: 1985-06 Impact factor: 22.682
Authors: Baburao Koneru; Adrian Fisher; Yan He; Kenneth M Klein; Joan Skurnick; Dorian J Wilson; Andrew N de la Torre; Anand Merchant; Rakesh Arora; Arun K Samanta Journal: Liver Transpl Date: 2005-02 Impact factor: 5.799
Authors: Daniel Azoulay; Massimo Del Gaudio; Paola Andreani; Philippe Ichai; Mylène Sebag; René Adam; Olivier Scatton; Bao Yan Min; Valérie Delvard; Antoinette Lemoine; Henri Bismuth; Denis Castaing Journal: Ann Surg Date: 2005-07 Impact factor: 12.969
Authors: Michael J J Chu; Ryash Vather; Anthony J R Hickey; Anthony R J Phillips; Adam S J R Bartlett Journal: Biomed Res Int Date: 2015-02-10 Impact factor: 3.411