In general, the liver is considered to be larger in males than in females. In the present study, data on liver weight from 728 legal autopsies were analyzed with respect to gender, age, body height (BH), body weight (BW), body mass index (BMI), and body surface area (BSA). Descriptive statistics revealed that liver weight increases with age, reaching maximum values between 41 and 50 years in men and between 51 and 60 years in women. Thereafter, liver weight decreases again. Because this loss in liver weight starts earlier in men while liver weight continues to rise in women, the difference in liver weight between men and women is lost above the age of 50. Thus, this age defines a threshold value below which gender is expected to be a critical factor in the calculation of liver weight. When demographic data mentioned above were subjected to multiple stepwise linear regression analysis, liver weight (LW) was best predicted in younger people (16 -50 years) by body weight, age, and gender: LW (g) ‫؍‬ 452 ؉ 16.34 ؋ BW ؉ 11.85 ؋ age ؊ 166 ؋ gender (r 2 ‫؍‬ 0.381; "gender": 1 ‫؍‬ female, 0 ‫؍‬ male). In contrast, in elderly people (51 -70 years) LW was best predicted by BW and age only. Gender was not a significant factor. LW (g) ‫؍‬ 1390 ؉ 15.94 ؋ BW ؊ 12.86 ؋ age (r 2 ‫؍‬ 0.35). When these formulas were applied to demographic data from 97 organ donors and compared to published formulas (which, however, do not consider the age-dependent effects of gender), the new formulas best predicted male to female liver weight ratios in younger and elderly donors. In conclusion, the new formulas might better predict liver weight in organ donors and transplant recipients to avoid liver size mismatch. (Liver Transpl 2004;10:678-685.)

Ischaemic preconditioning provides both better intraoperative haemodynamic stability and anti-ischaemic effects thereby allowing us to take full advantage of blood loss reduction by the Pringle manoeuvre.

The adenosine diphosphate (ADP)-adenosine triphosphate (ATP) carrier of the inner mitochondrial membrane is identified as an autoantigen in myocarditis and dilated cardiomyopathy. Sera of patients with these diseases contain autoantibodies to the ADP-ATP carrier capable of inhibiting nucleotide transport in vitro. Recently, an antibody-related infringement of energy metabolism was shown in intact perfused hearts isolated from guinea pigs immunized with the ADP-ATP carrier. A decreased cytosolic-mitochondrial difference of the phosphorylation potential of ATP was measured that originated from a reduction in mitochondrial-cytosolic nucleotide transport. Nonimmunized animals did not show these changes in energy metabolism, despite being in a comparable metabolic state and performing equal external heart work. To establish whether antibodies to the ADP-ATP carrier can also alter cardiac function, hemodynamic parameters of isolated hearts of guinea pigs that were preimmunized with the carrier protein were measured. Cardiac metabolism was stimulated by exposing the hearts to a high calcium concentration in conjunction with a maximum elevation of the afterload. Mean aortic pressure, stroke volume, stroke work, and external heart work were found to be lowered significantly (p<0.005). The external heart work of the immunized hearts reached only about 201% of the level performed by control hearts. Myocardial oxygen consumption was lowered 2.5-fold, whereas the extent of lactate production was found to be more than doubled. These results show a diminished cardiac performance of hearts from animals immunized with the ADP-ATP carrier. Our findings demonstrate that autoimmunity to the ADP-ATP carrier may contribute to the pathophysiology of dilated cardiomyopathy as a subsequent stage of myocarditis by causing an autoantibody-mediated reduction in cardiac function on the basis of an imbalance between energy delivery and demand. (Circulation 1990;81:959-969 of the animals were measured. While mitochondrial ATP and cytosolic ADP levels were raised, mitochondrial ADP and cytosolic ATP levels declined. As a consequence, the mitochondrial value of the phosphorylation potential of ATP was markedly higher and the cytosolic value was lower than in the hearts of nonimmunized control animals.7 These data indicate that the autoantibodies found in patients with myocarditis and dilated cardiomyopathy may not be merely an epiphenomenon. Furthermore, our results provide first evidence for a possible novel mechanism of an immunologically mediated dysfunction of the myocardial cell, namely, due to energy deficiency. The present study was designed to consider whether this observed disturbance in myocardial energy metabolism also leads to an alteration of myocardial function. Methods Isolation of the ADP-ATP CarrierBeef heart mitochondria were isolated as described by Smith.8 The solubilization and isolation of the ADP-ATP carrier followed the procedure previously described.9-12 The bovine and the guinea pig antigen are equally suited for immun...

Intravenous GSH administration during reperfusion of ischemic livers prevents reperfusion injury in rats. Because GSH is well tolerable also in man, this novel approach could be introduced to human liver surgery.

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