ABSTRACT
<p><b>OBJECTIVES</b>To evaluate the protective effects of affiliating portasystemic shunt on small-for-size graft in liver transplantation.</p><p><b>METHODS</b>Fifteen Chinese Bama miniature pigs were divided into three groups: group A (small-for-size liver transplantation), group B (distal splenorenal shunt + small-for-size liver transplantation), and group C (mesocaval H-shape shunt + small-for-size liver transplantation). Animals were followed up for 7 days with survival, dynamical liver function biochemical parameters, liver biopsies, portal venous pressure (PVP) and portal blood flow (PBF).</p><p><b>RESULTS</b>Animal survivals were as follows: group A, 1/5, group B, 3/5 and group C, 5/5.Group A resulted in abnormal liver function parameters that were significantly ameliorated in group B and C. The histological examination of graft in group A displayed severe pathologic changes including hepatocyte vacuolar change or necrosis, sinusoidal congestion, parenchymal hemorrhage. Affiliating portasystemic shunt significantly alleviated graft injuries in group B and C. PVP rose and peaked up to 28.6 mm Hg (1 mm Hg = 0.133 kPa), PBF fluctuated after reperfusion in group A, but group B and C with affiliating portasystemic shunt showed significantly lower PVP and maintained rather stable PBF after reperfusion. There were also statistical differences in PVP or PBF between group B and C.</p><p><b>CONCLUSIONS</b>Affiliating portasystemic shunt effectively might protect small-for-size graft from injuries after reperfusion.</p>
Subject(s)
Animals , Female , Male , Liver , Pathology , Liver Transplantation , Models, Animal , Portal Pressure , Portal Vein , Physiology , Portasystemic Shunt, Surgical , Methods , Random Allocation , Regional Blood Flow , Survival Rate , Swine , Swine, MiniatureABSTRACT
<p><b>OBJECTIVE</b>To evaluate the safety and reliability of cyclosporine microemulsion (CsA-ME) C(2) monitoring and to determine the target level of C(2) in Chinese adult liver transplant recipients.</p><p><b>METHODS</b>53 Chinese adult liver transplant recipients were randomly divided into three groups (group C(0), n = 17; group high level C(2), n = 18; group low level C(2), n = 18). Blood chemistry reflecting heart, liver and renal function and CsA level were examined at certain interval during follow-up. The change of immune status and episodes of rejection were also observed closely.</p><p><b>RESULTS</b>The group low level C(2) had the lowest CsA oral dose (2.51 +/- 0.37 mg/kg/d), and had significant difference compared with the other groups (P < 0.01). The best liver, heart and renal function was observed in group low level C(2). The CD(4)(+)/CD(8)(+) ratio of group low level C(2) was 1.04 +/- 0.68, which had no significant difference with C(0) group. The rejection incidence of the three groups had no significant difference. group low level C(2) had highest clinical benefit ratio (72.22%), while the clinical benefit of group high level C(2) is the lowest (11.11%).</p><p><b>CONCLUSIONS</b>With rational target level, C(2) monitoring can show us the proper oral dose of CsA which can decrease the side effects remarkably without rejection episodes increasing. The target level of C(2) in Chinese adult liver transplant recipients might be: 600-800 ng/ml 1 to 6 months posttransplant, 400-600 ng/ml 7-12 months posttransplant.</p>
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Administration, Oral , Cyclosporine , Pharmacokinetics , Drug Monitoring , Emulsions , Follow-Up Studies , Graft Rejection , Immunosuppressive Agents , Pharmacokinetics , Liver Transplantation , Allergy and Immunology , Postoperative Period , Transplantation, HomologousABSTRACT
<p><b>OBJECTIVE</b>To analyze the correlation between drug exposure (AUC0-4) and blood concentration of different sample points during Neoral absorption phase in Chinese adult liver transplant recipients, and to evaluate the possibility of using post-dose 2 hour level (C2) as a surrogate marker of AUC0-4 for the therapeutic drug monitoring (TDM) of Neoral.</p><p><b>METHODS</b>Neoral levels at 0, 1, 2, 3, and 4 hours (C1, C2, C3, C4) after morning dose of 22 de novo Chinese adult liver transplant recipients were monitored during different posttransplant periods. Liner regression was used to analyze the correlation between CsA concentration at different time points and the AUC0-4.</p><p><b>RESULTS</b>The best correlation was found at C2, while the correlation of C0 was the lowest. During following-up, the correlation between C2 and AUC0-4 was very stable.</p><p><b>CONCLUSION</b>C2 had the best correlation with drug exposure. This correlation is very stable. C2 may be used as a good surrogate marker of AUC0-4 for the TDM of Neoral.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Area Under Curve , Asian People , Cyclosporine , Blood , Pharmacokinetics , Drug Monitoring , Methods , Emulsions , Graft Rejection , Immunosuppressive Agents , Blood , Pharmacokinetics , Intestinal Absorption , Physiology , Liver Transplantation , Allergy and Immunology , Monitoring, Immunologic , Methods , Postoperative PeriodABSTRACT
Objective To study the effect of portal vein blocking on the permeability of the intestinal mucosa in pigs. Methods Healthy Rongchang pigs were divided into 3 groups: ① sham operation group(SO), ② portal vein clamping for 45 min group (PVC-45'), ③ portal vein clamping for 60 min group (PVC-60'). Urine lactulose/mannitol(L/M) ratio was measured after portal vein blocking. Results The L/M ratio was increased significantly (P<0.05) in PVC-45' and 60' groups than in SO group, with that of PVC-60' higher than that of PVC-45' group, but not significantly. Conclusion The increase of intestinal mucosal permeability after portal vein blocking is an early and important index for the damage of the intestinal mucosa barrier.
ABSTRACT
Objective To study the effect of portal vein blocking on the permeability of the intestinal mucosa in pigs. Methods Healthy Rongchang pigs were divided into 3 groups: ① sham operation group(SO), ② portal vein clamping for 45 min group (PVC-45'), ③ portal vein clamping for 60 min group (PVC-60'). Urine lactulose/mannitol(L/M) ratio was measured after portal vein blocking. Results The L/M ratio was increased significantly (P<0.05) in PVC-45' and 60' groups than in SO group, with that of PVC-60' higher than that of PVC-45' group, but not significantly. Conclusion The increase of intestinal mucosal permeability after portal vein blocking is an early and important index for the damage of the intestinal mucosa barrier.