Inflamatory markers in cadaveric versus living-donor livers

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Inflamatory markers in cadaveric versus living-donor livers

Cold ischemia causes platelet deposition and neutrophil infiltration after

reperfusion of cadaveric liver allografts, find doctors in the latest issue

of Transplantation.

Prolonged cold storage of organs for transplantation may lead to

inflammatory damage upon reperfusion.

In this study, doctors from England investigated whether organs from living

donors experience less damage upon reperfusion than those retrieved from

cadaver donors. The team obtained biopsies from 23 cadaveric and 10

living-related donor liver transplants, both before and 2 hours after

reperfusion.

Cryosections were stained with antibodies against neutrophils, platelets,

activated platelets, and endothelium.

Living-related donor liver allografts showed minimal changes

postreperfusion.

Transplantation

The team found that the LRD liver allografts showed minimal changes

postreperfusion.

However, in cadaver allografts, neutrophil infiltration was detected in

22%. Increased expression of von Willebrand factor (vWF), CD41, and

P-selectin occurred in 48%, 30%, and 13% of allografts, respectively.

In cadaver allografts with deposition of activated platelets expressing

either P-selectin or vWF, the cold ischemia time was significantly longer

(885 versus 608 minutes, 776.8 versus 559 minutes, respectively).

Increases in neutrophils and platelets after reperfusion were not

significantly associated with clinical events posttransplant.

However, in cadaver transplants that experienced early acute rejection, the

mean cold ischemia time was significantly longer than in allografts with no

rejection (732 versus 480 minutes).

Dr Wayel Jassem's team concluded, " This study demonstrates that in the

clinical situation, cold ischemia causes platelet deposition and neutrophil

infiltration after reperfusion of cadaveric liver allografts " .

" These early inflammatory events may contribute to make the graft more

susceptible to acute rejection " .

Transplant 2003; 76(11): 1599-1603

18 December 2003