Reduction of ischemia-reperfusion injury in parenchymal and nonparenchymal liver cells by donor treatment with DL-alpha-tocopherol prior to organ harvest.

GONDOLESI GE1; LAUSADA N; SCHINELLA G; SEMPLICI AM; VIDAL MS; LUNA GC; TOLEDO J; DE BUSCHIAZZO PM; RAIMONDI JC

TRANSPLANTATION PROCEEDINGS

ELSEVIER SCIENCE INC

Lugar: Amsterdam; Año: 2002 vol. 34 p. 1086 - 1091

0041-1345

The increasing number of potential liver transplant recipients does not correlate with a parallel increase in the number of donors. Many strategies have been proposed to address this imbalance, including liberalization of donor selection criteria with a consequent increase in the use of marginal donors, an approach that carries an increased risk of primary graft dysfunction (PGD). The wide range of PGD varies from minor biochemical abnormalities to a 7% to 30% risk of primary nonfunction (PNF),1 which leads to retransplantation or death. It is well known that PGD results from a variety of factors. Some of these factors are related to the donor (eg, age, steatosis, body mass index, arterial hypertension, dyslipemia, alcoholism, anti-HBcAg), others to donor maintenance (eg, hypoxia, hypernatremia, hypotension, inotropic requirements, acidosis, cardiac arrest), or organ storage (eg, preservation solution, cold and warm ischemia times), or reperfusion damage.2 While many factors that cause PGD are immutable, others are susceptible to modification.Considerable advances have been made in understanding the pathogenesis of and developing therapeutic strategies for the ischemia/reperfusion injury. We hypothesized that one way to reduce organ damage was to improve the quality of the donor liver via a preharvesting treatment. Previously, we showed that hepatic antioxidant capability was increased three- to ten-fold3 by preharvest IV administration of free-radical scavengers. In the present study, we examined whether a 1-hour preharvest treatment of the donor with IV dl-α-tocopherol (α-T) reduced parenchymal and nonparenchymal cell reperfusion injury in rat livers.