The effects of hepatic ischemia can be analyzed with a wide variety of functional and morphological methods. In this study we used a new organ monitoring device that accurately determines pH and K+ activities on the liver surface with ion-selective electrodes. Four groups of rats (n = 6 each) were subjected to complete, arterial or portal warm ischemia for 15 min (achieved by clamping of the hepatoduodenal ligament, the hepatic artery or the portal vein) and subsequent reperfusion. One group was sham-operated. Complete and portal ischemia were characterized by an immediate decline of pH and a more retarded rise of K+ activity on the liver surface. Arterial ischemia had almost no effect on these two parameters when compared with the sham group. Upon reperfusion the shifts of pH and K+ activity reversed towards initial baseline values. The organ monitoring system offers the option to assess ional shifts non-invasively during organ procurement, ischemia and reperfusion and may be used as an additional criterion for the estimation of organ viability.
Lidocaine metabolism (MEGX test) as an indicator for liver function in the assessment of different degrees of liver disease and as a predictor for liver outcome after transplantation is well established. Since reduced liver function is associated with an alteration in parenchymal and non-parenchymal cells, we evaluated whether MEGX values correlate with histology in an in vivo model of orthotopic rat liver transplantation (ORLT) to assess histological damage without taking biopsy specimens. Livers from syngeneic Lewis rats were transplanted with rearterialization after 15-30 h of cold storage in UW solution and rinsing with Carolina Rinse Solution prior to implantation. Forty-eight hours after transplantation, the MEGX test was performed and metabolites were measured with a commercial kit as described elsewhere. Biopsy specimens were taken and graded three degrees of damage (mild, moderate, and severe) in a double blind fashion by a pathologist. MEGX values were assigned to the histological results. Statistical analyses were done with a Mann-Whitney test (n = 58) for mean values. The mean MEGX values attributed to histologies with a mild, moderate, severe degree of damage were 159.96, 78.46 and 44.42 ng/ml, respectively. When the histological groups were compared with the mean MEGX values, mild vs moderate, mild vs severe and moderate vs severe were significant (P - 0.0001). In conclusion, MEGX values correlate significantly with histological grading in a linear fashion after ORLT. The MEGX test may be of clinical value because it reflects the histological pattern of livers and may reduce the necessity to take biopsy specimens before and after transplantation.
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