Ischemia Reperfusion Liver Transplantation And Gastric Mucosal Injury

Removal the failure end-stage liver and implant a whole or part of the same organ by surgical operation to acquire the normal liver function, called liver transplantation. In 1956. Cannon first performed the orthotopic liver transplantation and successfully performed by moor in!959 in dogs, and the first attempt at liver allotransplantation in man was made by Starzl at the University of Colorado on March . 1. 1963. Up to the present . there were 40years.Now the survival rate after liver transplantation increased significant along with the improve of surgical techniques and research on immunosuppression and the experience demonstrate that liver transplantation has become a effective approach for end-stage liver failure. Liver transplantation not only prolong the life time of patients , but also can get high life quality, some patients can go to work after liver transplantation.Portal hypertension is a clinical s>ndrome that is accompanied with portal pressure above the normal, caused by increase hepatic vascular resistance and enlargement volume of portal venous blood flow, portal hypertension causes a major phenomena:upper gastrointestinal bleeding. The mortality of first upper gastrointestinal bleeding is about 50%. more then 30% persent patients with portal h\pertension dead from upper gastrointestinal bleeding. Recent years research indicate when the portal pressure was above normal 5-10 mmHg, blood flow in vascular of stomach enlarged obviously and cause micorvascular dilatation. Local oxygen free radical expression and concentration of c\1okine for exampleTNF IL-8 et al increased .induce the demage of gastric mucosa. lead to portal hypertensive gastritis, manifestated hyperemia ^ edema - erosion in gastric mucosa. cause upper gastrointestinal bleeding.Liver transplantation is a new method to treat portal hypertension . The experience tell us that liver transplantation effectively decrease portal pressure, return the low blood velocity in portal vein to normal.WBC count and the platelet count returned to normal . rebleeding rate after liver transplantation decreased . 5 yeras survival rate was higher then other types operation for treat portal hypertension. All above show us the dominance about liver transplantation. So experts pay more attention on hemod\Tianiics change and liver injury but the change on gastric mucosa especially on PHG was insufficient.This paper through establish models of ischemia-reperfusion ., liver cirrhosis > liver transplantation in rats to investigate the TNF IL-8 change in gastric mucosa and blood ;expression TNF IL-8 mRNA in cells; pathological change under microscopy .the results were follows:1) after ischemia-reperfusion , gastric mucosa manifested hyperemia > edema and soakage of neutrophils ;some cases pathological change manifested degeneration and erosion under light microscopy.2) Pathological change of PHG exhibite ulceration x erosion . when we performe I/R. h\peremia and edema in gastric mucosa aggravated..3) Gastric mucosal structure after liver transplantation also manifested hypemia > edema , infiltration of leukocyte.Ulcers and erosion can also get in some rats.Injury on gastric mucosa of treated rats was lighten then others.4) Morphology on electronic microscopy manifested dilatation of SER and nutochondrion;karyopyknisis;karyoK'sis:cell necrosis.5) TNF and IL-8 levels elevated after I/R> liver transplantation peaked at 24h, decreased at 72h., PHG group and OLT group expressed significantly than simple I/R group. There was a slight decrease TNF IL-8 concentration in blood in group treat with Famotidine , but decreased obviously in gastric mucosa.6) TNF mRNA and IL-8mRNA were began to express after I/R or OLT . Low expressionin simple I/R group . but strongly express in PHG and OLT group, and express marklyhigher at 24h after operation.