Effects of tacrolimus on reperfusion injury in orthotopic liver transplantation / 中华消化外科杂志

ABSTRACT

Objective To investigate the effects of tacrolimus on reperfusion injury in orthotopic liver transplantation.Methods The rat models of orthotopic liver transplantation were established.SD rats in experimental group(n=40)were injected with tacrolimus while control group(n=40)with normal saline.The serum levels of TNF-α,IL-1,ALT,AST,LDH,endothelin(ET)and malondialdehyde(MDA)were detected at 24,48,96 hours after reperfusion.Uhrastruetural changes and cellular apoptosis of liver and synthesis of mRNA of Fas and Bcl-2 were checked. According to the immunosuppression regimen,112 patients with end-stage liver cirrhosis were divided into tacrolimus group(n=63)and cyclosporin A group(n=49).The levels of hepatic enzymes and the rate of acute rejection in patients of the two groups after liver transplantation were compared.Results Levels of TNF-α,IL-1,AIJT,AST,LDH,ET and MDA in experimental group were significantly lower than those in control group(P＜0.05).Rats in experimental group had less Fas mRNA synthesis.minor liver ultrastructure lesion and cellular apoptosis than control group.Compared with cyclosporin A group,acute rejection was decreased in tacrolimus group(x2=39.0,P＜0.05).Conclusions Tacrolimus may lessen reperfusion injury and cellular apoptosis in rat orthotopic liver transplantation,and it may also alleviate reperfusion injury in human liver transplantation and reduce the rate of acute rejection.