Microvascular graft dysfunction

Balabaud, Charles; Cunha, Antonio Sa; Bioulac‐Sage, Paulette

doi:10.1016/j.jhep.2004.07.001

Cited by 4 publications

(3 citation statements)

References 16 publications

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“…Deterioration of the hepatic microcirculation as described after ischemia/reperfusion (I/R) is associated with an increased risk of EAD . Analysis of the hepatic microcirculation is therefore fundamental in understanding important aspects of the transplanted organ's physiology and pathophysiology.…”

Section: Discussionmentioning

confidence: 99%

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Postreperfusion microcirculatory derangements after liver transplantation: Relationship to hemodynamics, serum mediators, and outcome

et al. 2017

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Despite the growing data supporting the role of microcirculation in regulating liver function, little of this knowledge has been translated into clinical practice. The aim of this study is to quantify hepatic microcirculation in vivo using sidestream dark field (SDF) imaging and correlate these findings with hepatic blood flow, hemodynamic parameters, and soluble mediators. Postreperfusion hepatic microcirculation was assessed using SDF imaging. Hepatic microcirculation measurements included functional sinusoidal density (cm/cm ), sinusoidal diameter (μm), red blood cell velocity (μm/second), volumetric blood flow (pl/second), and flow heterogeneity (FH) index. The serum concentrations of endothelin 1 (ET-1) and other inflammatory markers were analyzed with Luminex technology. Portal venous and hepatic artery flows were measured using a flowmeter. Twenty-eight patients undergoing cadaveric liver transplantations have been included in this study. Early allograft dysfunction (EAD) occurred in 7 (25%) patients and was associated with microcirculatory dysfunction. Low arterial and portal flow, high dose of inotropes, cold ischemia time, steatosis, and high ET-1 levels were all associated with impaired microcirculation. The time interval between portal venous and hepatic arterial reperfusion significantly correlated with the changes of the liver grafts' microcirculation. EAD patients tended to have higher serum levels of ET-1 on postoperative days 1, 2, 5, and 7 (all P < 0.01). Serum levels of ET-1 correlated significantly with microcirculation parameters. In conclusion, postreperfusion hepatic microcirculation is a determinant of organ dysfunction after liver reperfusion and could be used to identify very early patients at risk of EAD. Liver Transplantation 23 527-536 2017 AASLD.

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Section: Discussionmentioning

confidence: 99%

“…Derangement of the microcirculation after full‐size liver transplantation (LT) is thought to depend mainly on the severity of IRI and graft quality . Thus, assessing microcirculation, which is in turn affected in IRI, could estimate graft damage and subsequent dysfunction in LT.…”

mentioning

confidence: 99%

Postreperfusion microcirculatory derangements after liver transplantation: Relationship to hemodynamics, serum mediators, and outcome

et al. 2017

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“…While endothelial loss or damage occurs in all solid organ allografts, once the allograft is duly revascularized and is functioning, the vasculature is once again protected. This enables physiologic, homeostatic self‐repair and prevents further damage and tissue fibrosis . However, because lung grafts completely lose bronchial artery circulation, they inevitably lose the chance for repair and recovery from the insults inherent to transplantation, limiting long‐term graft survival .…”

Section: Discussionmentioning

confidence: 99%

A Novel Dual Ex Vivo Lung Perfusion Technique Improves Immediate Outcomes in an Experimental Model of Lung Transplantation

Tanaka

Noda

Isse

et al. 2015

American Journal of Transplantation

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The lungs are dually perfused by the pulmonary artery and the bronchial arteries. This study aimed to test the feasibility of dual‐perfusion techniques with the bronchial artery circulation and pulmonary artery circulation synchronously perfused using ex vivo lung perfusion (EVLP) and evaluate the effects of dual‐perfusion on posttransplant lung graft function. Using rat heart‐lung blocks, we developed a dual‐perfusion EVLP circuit (dual‐EVLP), and compared cellular metabolism, expression of inflammatory mediators, and posttransplant graft function in lung allografts maintained with dual‐EVLP, standard‐EVLP, or cold static preservation. The microvasculature in lung grafts after transplant was objectively evaluated using microcomputed tomography angiography. Lung grafts subjected to dual‐EVLP exhibited significantly better lung graft function with reduced proinflammatory profiles and more mitochondrial biogenesis, leading to better posttransplant function and compliance, as compared with standard‐EVLP or static cold preservation. Interestingly, lung grafts maintained on dual‐EVLP exhibited remarkably increased microvasculature and perfusion as compared with lungs maintained on standard‐EVLP. Our results suggest that lung grafts can be perfused and preserved using dual‐perfusion EVLP techniques that contribute to better graft function by reducing proinflammatory profiles and activating mitochondrial respiration. Dual‐EVLP also yields better posttransplant graft function through increased microvasculature and better perfusion of the lung grafts after transplantation.

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Lebertransplantation

Lackner¹,

Huebscher²

2020

Pathologie

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Microvascular graft dysfunction

Cited by 4 publications

References 16 publications

Postreperfusion microcirculatory derangements after liver transplantation: Relationship to hemodynamics, serum mediators, and outcome

Postreperfusion microcirculatory derangements after liver transplantation: Relationship to hemodynamics, serum mediators, and outcome

A Novel Dual Ex Vivo Lung Perfusion Technique Improves Immediate Outcomes in an Experimental Model of Lung Transplantation

Lebertransplantation

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