Prediction of rat liver transplantation outcomes using energy metabolites measured by microdialysis.

BACKGROUND: Warm ischemia jeopardizes graft quality and recipient survival in donation after cardiac death (DCD) transplantation. Currently, there is no system to objectively evaluate the liver quality from DCD. The present study tried to use energy metabolites to evaluate the donor liver quality. METHODS: We divided 195 Sprague-Dawley rats into five groups: the control (n = 39), warm ischemic time (WIT) 15 min (n = 39), WIT 30 min (n = 39), WIT 45 min (n = 39), and WIT 60 min (n = 39) groups. Three rats from each group were randomly selected for pretransplant histologic evaluation of warm ischemia-related damage. The remaining 36 rats were randomly divided into donors and recipients of 18 liver transplantations, and were subjected to postoperative liver function and survival analyses. Between cardiac arrest and cold storage, liver energy metabolites including glucose, lactate, pyruvate, and glycerol were measured by microdialysis. The lactate to pyruvate ratio (LPR) was calculated. RESULTS: The changes in preoperative pathology with warm ischemia were inconspicuous, but the trends in postoperative pathology and aminotransferase levels were consistent with preoperative energy metabolite measurements. The 30-day survival rates of the control and WIT 15, 30, 45, and 60 min groups were 100%, 81.82%, 76.92%, 58.33%, and 25.00%, respectively. The areas under the receiver operating characteristic curves of glucose, lactate, glycerol, and LPR were 0.87, 0.88, 0.88, and 0.92, respectively. CONCLUSION: Glucose, lactate, glycerol, and LPR are predictors of graft quality and survival outcomes in DCD transplantation.

Colorectal liver metastases rarely occur in patients with chronic hepatitis virus infection.

BACKGROUND/AIMS: There are studies that report that liver metastases rarely occur in patients with cirrhosis. This study evaluates the relationship between the incidence of liver metastases from colorectal cancer (CRC) and chronic hepatitis virus infection in patients. METHODOLOGY: Three hundred and fifty-four cases of advanced CRC from our hospital were evaluated. The patients were divided into a chronic hepatitis virus infection group and a non-hepatitis virus infection group. The two groups were compared regarding the incidence of colorectal liver metastases and survival. The criterion of colorectal liver metastases was based on liver CT examination and intraoperative exploration results. RESULTS: There were two cases with colorectal liver metastases among the seventy cases of the chronic hepatitis virus infection group. The rate of liver metastases was 2.86%. There were 48 cases with colorectal liver metastases among 284 cases of the non-hepatitis virus infection. The rate of liver metastases was 16.9%. The incidence of colorectal liver metastases between the two groups was significantly different (p<0.01). Five-year survival rates were 60% and 40.8% in the chronic hepatitis virus infection group and the non-hepatitis virus infection group, respectively (p<0.05). The degree of progress in the two groups of patients showed no significant difference. CONCLUSIONS: Colorectal liver metastases occur rarely with chronic hepatitis virus infection and the patients in our study had good prognoses.