19 January 2015 : Original article
Isoflurane does not Protect from Brain Death-Associated Aggravation of Cold Hepatic Ischemia-Reperfusion InjuryMoritz J. StrowitzkiBCEF, Mohammed R. MoussavianACG, Ulrich KepplerBC, Martin K. SchillingADG, Michael D. MengerADEF, Maximilian von HeesenABCDEFG
Ann Transplant 2015; 20:36-43
BACKGROUND: Previous studies have shown that brain death aggravates cold ischemia-reperfusion injury in liver transplantation. Isoflurane, a volatile anesthetic, has been indicated to reduce warm hepatic ischemia-reperfusion injury. Herein, we studied in Sprague-Dawley rats whether isoflurane is capable of ameliorating brain death-associated aggravation of cold hepatic ischemia-reperfusion injury.
MATERIAL AND METHODS: Brain-dead animals were treated for 30 min with isoflurane (MAC 1.5%; n=8). Animals without isoflurane treatment served as controls (n=8). Another 13 animals without induction of brain death served as sham controls. After a 4-h period portal venous blood perfusion, hepatic microcirculation and bile flow were determined. Livers were recovered and stored for 24 h in 4°C cold HTK solution, followed by reperfusion with 37°C Krebs-Henseleit-buffer for 60 min. Liver enzymes in the effluent and bile flow were analyzed. Hepatocellular morphology was determined by histology and immunohistochemistry.
RESULTS: Brain death reduced portal venous blood perfusion and bile flow, induced heme oxygenase-1 (HO-1), and resulted in hepatocellular damage. Isoflurane treatment did not prevent the reduction of portal venous blood perfusion or bile flow or the induction of HO-1. Accordingly, isoflurane was not capable of reducing the hepatocellular injury.
CONCLUSIONS: Isoflurane does not protect from brain death-associated aggravation of cold hepatic ischemia-reperfusion injury.
Keywords: Brain Death, Isoflurane, Reperfusion Injury
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