Effects of Subnormothermic Regulated Hepatic Reperfusion on Mitochondrial and Transcriptomic Profiles in a Porcine Model.


Journal

Annals of surgery
ISSN: 1528-1140
Titre abrégé: Ann Surg
Pays: United States
ID NLM: 0372354

Informations de publication

Date de publication:
01 02 2023
Historique:
pmc-release: 01 02 2024
pubmed: 14 8 2021
medline: 9 2 2023
entrez: 13 8 2021
Statut: ppublish

Résumé

We sought to investigate the biological effects of pre-reperfusion treatments of the liver after warm and cold ischemic injuries in a porcine donation after circulatory death model. Donation after circulatory death represents a severe form of liver ischemia and reperfusion injury that has a profound impact on graft function after liver transplantation. Twenty donor pig livers underwent 60 minutes of in situ warm ischemia after circulatory arrest and 120 minutes of cold static preservation prior to simulated transplantation using an ex vivo perfusion machine. Four reperfusion treatments were compared: Control-Normothermic (N), Control- Subnormothermic (S), regulated hepatic reperfusion (RHR)-N, and RHR-S (n = 5 each). The biochemical, metabolic, and transcriptomic profiles, as well as mitochondrial function were analyzed. Compared to the other groups, RHR-S treated group showed significantly lower post-reperfusion aspartate aminotransferase levels in the reperfusion effluent and histologic findings of hepatocyte viability and lesser degree of congestion and necrosis. RHR-S resulted in a significantly higher mitochondrial respiratory control index and calcium retention capacity. Transcriptomic profile analysis showed that treatment with RHR-S activated cell survival and viability, cellular homeostasis as well as other biological functions involved in tissue repair such as cytoskeleton or cytoplasm organization, cell migration, transcription, and microtubule dynamics. Furthermore, RHR-S inhibited organismal death, morbidity and mortality, necrosis, and apoptosis. Subnormothermic RHR mitigates IRI and preserves hepatic mitochondrial function after warm and cold hepatic ischemia. This organ resuscitative therapy may also trigger the activation of protective genes against IRI. Sub- normothermic RHR has potential applicability to clinical liver transplantation.

Sections du résumé

OBJECTIVE
We sought to investigate the biological effects of pre-reperfusion treatments of the liver after warm and cold ischemic injuries in a porcine donation after circulatory death model.
SUMMARY OF BACKGROUND DATA
Donation after circulatory death represents a severe form of liver ischemia and reperfusion injury that has a profound impact on graft function after liver transplantation.
METHODS
Twenty donor pig livers underwent 60 minutes of in situ warm ischemia after circulatory arrest and 120 minutes of cold static preservation prior to simulated transplantation using an ex vivo perfusion machine. Four reperfusion treatments were compared: Control-Normothermic (N), Control- Subnormothermic (S), regulated hepatic reperfusion (RHR)-N, and RHR-S (n = 5 each). The biochemical, metabolic, and transcriptomic profiles, as well as mitochondrial function were analyzed.
RESULTS
Compared to the other groups, RHR-S treated group showed significantly lower post-reperfusion aspartate aminotransferase levels in the reperfusion effluent and histologic findings of hepatocyte viability and lesser degree of congestion and necrosis. RHR-S resulted in a significantly higher mitochondrial respiratory control index and calcium retention capacity. Transcriptomic profile analysis showed that treatment with RHR-S activated cell survival and viability, cellular homeostasis as well as other biological functions involved in tissue repair such as cytoskeleton or cytoplasm organization, cell migration, transcription, and microtubule dynamics. Furthermore, RHR-S inhibited organismal death, morbidity and mortality, necrosis, and apoptosis.
CONCLUSION
Subnormothermic RHR mitigates IRI and preserves hepatic mitochondrial function after warm and cold hepatic ischemia. This organ resuscitative therapy may also trigger the activation of protective genes against IRI. Sub- normothermic RHR has potential applicability to clinical liver transplantation.

Identifiants

pubmed: 34387201
doi: 10.1097/SLA.0000000000005156
pii: 00000658-202302000-00046
pmc: PMC8840998
mid: NIHMS1732116
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e366-e375

Subventions

Organisme : NCI NIH HHS
ID : P50 CA217674
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA237327
Pays : United States

Informations de copyright

Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

Déclaration de conflit d'intérêts

The authors report no conflicts of interest.

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Auteurs

Joohyun Kim (J)

Division of Transplant Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee WI.
Transplant Center, Froedtert & the Medical College of Wisconsin, and Children's Wisconsin, Milwaukee, WI.

Michael A Zimmerman (MA)

Division of Transplant Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee WI.
Transplant Center, Froedtert & the Medical College of Wisconsin, and Children's Wisconsin, Milwaukee, WI.

Woo Young Shin (WY)

Department of Surgery, inha University School of Medicine, incheon, South Korea.

Brent T Boettcher (BT)

Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI.

Ju-Seog Lee (JS)

Department of Systems Biology, The University of Texas MD Anderson Cancer Center, Houston, TX.

Jong-In Park (JI)

Department of Biochemistry, Medical College of Wisconsin, Milwaukee, WI.

Muhammed Ali (M)

Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI.

Meiying Yang (M)

Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI.

Jyotsna Mishra (J)

Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI.

Catherine E Hagen (CE)

Department of Pathology, Mayo Clinic, Rochester, MN.

Joseph E McGraw (JE)

Department of Pharmacology, Concordia University, Mequon, WI.

Angela Mathison (A)

Genomic Sciences and Precision Medicine Center, Medical College of Wisconsin, Milwaukee, WI; and.
Division of Research, Department of Surgery, Medical College of Wisconsin, Milwaukee WI.

Harvey J Woehlck (HJ)

Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI.

Gwen Lomberk (G)

Genomic Sciences and Precision Medicine Center, Medical College of Wisconsin, Milwaukee, WI; and.
Division of Research, Department of Surgery, Medical College of Wisconsin, Milwaukee WI.

Amadou K S Camara (AKS)

Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI.

Raul A Urrutia (RA)

Genomic Sciences and Precision Medicine Center, Medical College of Wisconsin, Milwaukee, WI; and.
Division of Research, Department of Surgery, Medical College of Wisconsin, Milwaukee WI.

David F Stowe (DF)

Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI.

Johnny C Hong (JC)

Division of Transplant Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee WI.
Transplant Center, Froedtert & the Medical College of Wisconsin, and Children's Wisconsin, Milwaukee, WI.

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