Liver glutathione depletion after preservation and reperfusion in human liver transplantation
PURPOSE: The oxidative stress is an important mechanism responsible for dysfunction after orthotopic liver transplantation (OLT). Glutathione (GSH) low levels after cold storage render the grafts vulnerable to reperfusion injury. Aim of this study was to evaluate GSH and oxidized glutathione (GSSG) liver concentrations, the hepatocellular injury and function in optimal and suboptimal grafts after human OLT. METHODS: Liver biopsies were taken in 33 patients before the implant and two hours after reperfusion, allowing determination of GSH, GSSG and oxidative stress ratio (GSH/GSSG). Serum transaminases, prothrombin activity (PT) and factor V were measured to evaluate injury and function respectively. Histopathological injury was analyzed by an index of five parameters. RESULTS: There was a decrease in GSH (p<0.01) after reperfusion (0.323 ± 0.062 ìmol/g to 0.095 ± 0.01 ìmol/g and 0.371 ± 0.052 ìmol/g to 0.183 ± 0.046 ìmol/g) in suboptimal and optimal groups, respectively. An increase of GSSG (p<0.05) occurred after reperfusion (0.172 ± 0.038 ìmol/g to 0.278 ± 0.077 ìmol/g and 0.229 ± 0.048 ìmol/g to 0.356 ± 0.105 ìmol/g) in suboptimal and optimal groups, respectively. A decrease (p<0.01) occurred in the GSH/GSSG ratio after reperfusion (2.23 ± 0.31 to 0.482 ± 0.042 and 2.47 ± 0.32 to 0.593 ± 0.068) in suboptimal and optimal groups, respectively. Histopathological injury scores were higher (p<0.05) in the suboptimal group than in optimal (6.46 ± 0.4 vs. 5.39 ± 1.1) and showed correlation with PT and factor V in the optimal group (p<0.05). Multivariate analysis pointed steatosis as an independent risk factor to histopathological injury (p<0.05). CONCLUSION: There was a significant GSH depletion and GSSG formation after cold storage and reperfusion due to a similar oxidative stress in optimal and suboptimal grafts, but these levels were not related to graft viability.
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Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia
2006
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oai:scielo:S0102-865020060004000072006-09-20Liver glutathione depletion after preservation and reperfusion in human liver transplantationGrezzana Filho,Tomaz de Jesus MariaCorso,Carlos OtávioZanotelli,Maria LúciaMarroni,Cláudio AugustoBrandão,Ajácio Bandeira MelloSchlindwein,EduardoLeipnitz,IanMeine,Mário Henrique MattosFleck Jr.,AlfeuHoppen,RicardoKiss,GuillermoCantisani,Guido Pio Cracco Liver Transplantation Oxidative Stress Glutathione PURPOSE: The oxidative stress is an important mechanism responsible for dysfunction after orthotopic liver transplantation (OLT). Glutathione (GSH) low levels after cold storage render the grafts vulnerable to reperfusion injury. Aim of this study was to evaluate GSH and oxidized glutathione (GSSG) liver concentrations, the hepatocellular injury and function in optimal and suboptimal grafts after human OLT. METHODS: Liver biopsies were taken in 33 patients before the implant and two hours after reperfusion, allowing determination of GSH, GSSG and oxidative stress ratio (GSH/GSSG). Serum transaminases, prothrombin activity (PT) and factor V were measured to evaluate injury and function respectively. Histopathological injury was analyzed by an index of five parameters. RESULTS: There was a decrease in GSH (p<0.01) after reperfusion (0.323 ± 0.062 ìmol/g to 0.095 ± 0.01 ìmol/g and 0.371 ± 0.052 ìmol/g to 0.183 ± 0.046 ìmol/g) in suboptimal and optimal groups, respectively. An increase of GSSG (p<0.05) occurred after reperfusion (0.172 ± 0.038 ìmol/g to 0.278 ± 0.077 ìmol/g and 0.229 ± 0.048 ìmol/g to 0.356 ± 0.105 ìmol/g) in suboptimal and optimal groups, respectively. A decrease (p<0.01) occurred in the GSH/GSSG ratio after reperfusion (2.23 ± 0.31 to 0.482 ± 0.042 and 2.47 ± 0.32 to 0.593 ± 0.068) in suboptimal and optimal groups, respectively. Histopathological injury scores were higher (p<0.05) in the suboptimal group than in optimal (6.46 ± 0.4 vs. 5.39 ± 1.1) and showed correlation with PT and factor V in the optimal group (p<0.05). Multivariate analysis pointed steatosis as an independent risk factor to histopathological injury (p<0.05). CONCLUSION: There was a significant GSH depletion and GSSG formation after cold storage and reperfusion due to a similar oxidative stress in optimal and suboptimal grafts, but these levels were not related to graft viability.info:eu-repo/semantics/openAccessSociedade Brasileira para o Desenvolvimento da Pesquisa em CirurgiaActa Cirúrgica Brasileira v.21 n.4 20062006-08-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-86502006000400007en10.1590/S0102-86502006000400007 |
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Grezzana Filho,Tomaz de Jesus Maria Corso,Carlos Otávio Zanotelli,Maria Lúcia Marroni,Cláudio Augusto Brandão,Ajácio Bandeira Mello Schlindwein,Eduardo Leipnitz,Ian Meine,Mário Henrique Mattos Fleck Jr.,Alfeu Hoppen,Ricardo Kiss,Guillermo Cantisani,Guido Pio Cracco |
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Grezzana Filho,Tomaz de Jesus Maria Corso,Carlos Otávio Zanotelli,Maria Lúcia Marroni,Cláudio Augusto Brandão,Ajácio Bandeira Mello Schlindwein,Eduardo Leipnitz,Ian Meine,Mário Henrique Mattos Fleck Jr.,Alfeu Hoppen,Ricardo Kiss,Guillermo Cantisani,Guido Pio Cracco Liver glutathione depletion after preservation and reperfusion in human liver transplantation |
author_facet |
Grezzana Filho,Tomaz de Jesus Maria Corso,Carlos Otávio Zanotelli,Maria Lúcia Marroni,Cláudio Augusto Brandão,Ajácio Bandeira Mello Schlindwein,Eduardo Leipnitz,Ian Meine,Mário Henrique Mattos Fleck Jr.,Alfeu Hoppen,Ricardo Kiss,Guillermo Cantisani,Guido Pio Cracco |
author_sort |
Grezzana Filho,Tomaz de Jesus Maria |
title |
Liver glutathione depletion after preservation and reperfusion in human liver transplantation |
title_short |
Liver glutathione depletion after preservation and reperfusion in human liver transplantation |
title_full |
Liver glutathione depletion after preservation and reperfusion in human liver transplantation |
title_fullStr |
Liver glutathione depletion after preservation and reperfusion in human liver transplantation |
title_full_unstemmed |
Liver glutathione depletion after preservation and reperfusion in human liver transplantation |
title_sort |
liver glutathione depletion after preservation and reperfusion in human liver transplantation |
description |
PURPOSE: The oxidative stress is an important mechanism responsible for dysfunction after orthotopic liver transplantation (OLT). Glutathione (GSH) low levels after cold storage render the grafts vulnerable to reperfusion injury. Aim of this study was to evaluate GSH and oxidized glutathione (GSSG) liver concentrations, the hepatocellular injury and function in optimal and suboptimal grafts after human OLT. METHODS: Liver biopsies were taken in 33 patients before the implant and two hours after reperfusion, allowing determination of GSH, GSSG and oxidative stress ratio (GSH/GSSG). Serum transaminases, prothrombin activity (PT) and factor V were measured to evaluate injury and function respectively. Histopathological injury was analyzed by an index of five parameters. RESULTS: There was a decrease in GSH (p<0.01) after reperfusion (0.323 ± 0.062 ìmol/g to 0.095 ± 0.01 ìmol/g and 0.371 ± 0.052 ìmol/g to 0.183 ± 0.046 ìmol/g) in suboptimal and optimal groups, respectively. An increase of GSSG (p<0.05) occurred after reperfusion (0.172 ± 0.038 ìmol/g to 0.278 ± 0.077 ìmol/g and 0.229 ± 0.048 ìmol/g to 0.356 ± 0.105 ìmol/g) in suboptimal and optimal groups, respectively. A decrease (p<0.01) occurred in the GSH/GSSG ratio after reperfusion (2.23 ± 0.31 to 0.482 ± 0.042 and 2.47 ± 0.32 to 0.593 ± 0.068) in suboptimal and optimal groups, respectively. Histopathological injury scores were higher (p<0.05) in the suboptimal group than in optimal (6.46 ± 0.4 vs. 5.39 ± 1.1) and showed correlation with PT and factor V in the optimal group (p<0.05). Multivariate analysis pointed steatosis as an independent risk factor to histopathological injury (p<0.05). CONCLUSION: There was a significant GSH depletion and GSSG formation after cold storage and reperfusion due to a similar oxidative stress in optimal and suboptimal grafts, but these levels were not related to graft viability. |
publisher |
Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia |
publishDate |
2006 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-86502006000400007 |
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