The Effect Of Warm Ischemia Time Of The Donor Liver From Non-heart-beating Donors On Transplanted Liver In Rats

Objective(s):This study was divided into two parts.The first part is the establishment of orthotopic liver transplantation model of DCD donor liver in rats.The second part investigated the effect of different warm ischemic time on liver transplantation after liver transplantation in rats.Methods:(1)The establishment of rat DCD orthotopic liver transplantation model.The rat DCD donor orthotopic liver transplantation model was completed by double cooperation.(2)To investigate the effect of different warm ischemic time on the transplanted liver of rats after liver transplantation.The healthy adult male SD rats were selected.According to the difference of cardiac arrest time before the donor liver was obtained,the rats were divided into three groups:control group(warm ischemia 0 min group),hot ischemia group 10 min group W10 group,hot ischemia group 20 min group and group W20 group.After that,the SD-SD rat model of orthotopic liver transplantation with DCD was established.40 rats in each group each time were sacrificed onl,3and 7 days after operation to determine the function of the transplanted liver and to observe the morphology of the liver cells and their organelles by transmission electron microscope.To investigate the effect of different time of warm ischemia on DCD(donation after cardiac death-donor liver transplantation.Results:With the prolongation of the warm ischemia time of donor liver,the liver cells were damaged seriously and the recovery time was prolonged.With the prolongation of warm ischemia time,serum alanine transferase(alt)and aspartate transferase(AST)increased sharply at 24 h after liver transplantation in each group,compared with those in the control group(warm ischemia for 0 min).The longer the time of hot ischemia,the bigger the increase(P<0.05).The serum levels of ALT and AST recovered basically on the 3rd day after transplantation,and the serum alt increased again on the 7th day after transplantation,but it was between 1 day and 3 days after transplantation.With the prolongation of warm ischemic time,the degree of hepatocyte edema,endoplasmic reticulum dilatation and mitochondrial damage were gradually aggravated,especially after 20min transplantation,partial cristal dissolution,pyknosis and necrosis appeared.The recovery of cells and organelles was later than that of serology.On the first day after operation,there was no significant difference in the relative expression of AIF and Cyt protein between the three groups(P>0.05),On the 3rd and 7th day after operation,the relative expression of AIF protein in group C was higher than that in group A(P<0.05),but in group B was higher than that in group A(P<0.05).Conclusion(s):1.During the operation of DCD donor liver transplantation,the warm ischemia of donor liver mainly damaged the liver cells,and with the prolongation of the time of warm ischemia,the damage of the transplanted liver cells increased,and the function of the liver cells recovered earlier than its morphology.2.Mitochondrial morphologic changes and mitochondrial apoptosis-related proteins(cytochrome C and AIF)increased with the prolongation of warm ischemia time.