The present work supports the view that the true WC effect and its estimation are not equivalent. However, the way in which the WC response is defined does not alter its effect on target organs or cardiovascular risk profile.
Isolated liver perfusion was developed for the study of liver physiology and preservation. The recent development of new perfusion devices and appropriate liver preservation solutions prompted us to reconsider liver perfusion for the specific purpose of evaluating viability in terms of biochemical changes, paying special attention to modifications in the histological ultrastructure. Twenty-two isolated pig livers were perfused with autologous blood. Arterio-portal perfusions were carried out using an extracorporeal perfusion circuit with a hollow fibre membrane oxygenator. Four groups of pig livers were studied using three different liver flushing solutions [Ringer's lactate, EL-OHES, and University of Wisconsin (UW)] and two different oxygenation modalities. Liver function tests and histological studies were done. Our results revealed that a high partial oxygen pressure (PO,) level was deleterious to the ultrastructural elements of hepatocytes, in particular to the mitochondria. It was also associated with deficient metabolic performance, i. e., poor bile production and lack of aerobic metabolism.Normal blood gas values could be obtained with the use of air for liver oxygenation. Flushing of the liver with Ringer's lactate or a macromolecular solution such as ELOHES was associated with severe liver cell injuries, as reflected by a marked rise in liver enzymes and histological lesions. Satisfactory results were obtained when UW solution was used for liver harvesting. We conclude that an appropriate liver preservation solution, normal blood gas values, and normal physiological arterio-portal pressure and blood flow are essential for appropriate liver function with preservation of liver architecture and of hepatocyte ultrastructures. Total bilirubin in bile and Factor V are sensitive indicators of good liver function.
Serum transferrin receptor is considered as a reliable marker of iron status particularly when iron deficiency is associated with chronic disorders such as inflammation, infection or malignancy. The present study aims to illustrate the performances of a new fully automated assay using immunonephelometry. The intra and between-assay precision was found to be very good (CVs < 4%). In healthy subjects there was no statistically significant difference between men and women. With a cut-off of 1.76 mg/l for diagnosing iron deficiency either alone or combined with anemia of chronic diseases, the sensitivity and specificity were respectively 82% and 96.8%. Unlike conventional biochemical and hematological tests, soluble transferrin receptor was unaffected by confounding pathologies. In genetic hemochromatosis the concentration of soluble transferrin receptor was mostly decreased due to the regulatory effect of iron intracellular level. Our study confirms the reliability of soluble transferrin receptor for the assessment of iron status. It is now possible to assay soluble transferrin receptor, ferritin and transferrin on the same apparatus within 15 minutes.
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