Predicting liver warm ischemic injury from donor after cardiac death donors by microdialysis
10.3760/cma.j.issn.0254-1785.2018.06.010
- VernacularTitle:微量透析技术在评估心脏死亡猪肝脏热缺血损伤程度中的应用价值
- Author:
Dehui YI
1
;
Zhiye BAO
;
Hao LIU
;
Yongfeng LIU
Author Information
1. 中国医科大学附属第一医院普通外科教研室器官移植科
- Keywords:
Pigs;
Liver;
Warm ischemia;
Microdialysis technology;
Evaluation
- From:
Chinese Journal of Organ Transplantation
2018;39(6):369-373
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the relative indicators associated with warm ischemia time (WIT).Methods We established the porcine donor after cardiac death (DCD) model and monitored biochemical parameters (glucose,lactate,pyruvate,glycerol,and glutamate) changes of porcine livers at different WIT by microdialysis technique.The pathological changes were also observed during different WIT by HE staining.Results As the extension of WIT,the morphology injury of the graft aggravated:glucose and pyruvate levels slightly declined in the early stage,and then increased with WIT entension;glycerol levels increased with WIT entension;lactate levels and lactate/pyruvate ratio increased significantly after 20 min of WIT.The expression of lactate and lactate/pyruvate ratio were increased with the prolonged WIT.Pearson correlation analysis of all factors with liver ischemia time and liver pathological injury degree (P＜0.05) showed the obvious correlation between lactate,lactate/pyruvic acid ratio with liver ischemia time and liver pathological injury degree,and of positive correlation (P＜0.001,and correlation coefficients were 0.682 and 0.453 respectively).The ROC curve analysis revealed that the area under the curve was 0.950 for lactate,and 0.885 for pyruvate,respectively.When the critical value of lactic acid was 2.3736,the sensitivity was 90％ and specificity was 95％.When the critical value of lactate/pyruvate ratio was 0.0257,the sensitivity was 80％ and specificity was 83％.Conclusion The level of lactic acid and lactate/pyruvate ratio are significantly related to the WIT.These factors may be used as a predictor of donor liver warm ischemia injury.Reference range of these indicators needs further discussion based on larger sample research.
