Opposite acute potassium and sodium shifts during transplantation of hypothermic machine perfused donor livers
| Autor: | Rianne van Rijn, Masato Fujiyoshi, Alix P M Matton, Lara Hessels, Laura C. Burlage, Marieke T. de Boer, Koen Reyntjens, Maarten W. N. Nijsten, Ruben H J de Kleine, Peter Meyer, Aad P. van den Berg, Robert J. Porte |
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| Přispěvatelé: | Groningen Institute for Organ Transplantation (GIOT), Microbes in Health and Disease (MHD), Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE) |
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Hyperkalemia donors and donation Sodium Potassium Cold storage chemistry.chemical_element 030230 surgery HYPERKALEMIA MECHANISMS 03 medical and health sciences 0302 clinical medicine Internal medicine medicine REPERFUSION Immunology and Allergy Pharmacology (medical) PRESERVATION science Transplantation Machine perfusion liver transplantation organ perfusion and preservation business.industry UNIVERSITY-OF-WISCONSIN medicine.disease STATIC COLD-STORAGE Hypokalemia Endocrinology translational research chemistry hepatology 030211 gastroenterology & hepatology POSTREPERFUSION medicine.symptom business Reperfusion injury |
| Zdroj: | American Journal of Transplantation, 19(4), 1061-1071. Wiley |
| ISSN: | 1600-6135 |
| Popis: | Liver transplantation is frequently associated with hyperkalemia, especially after graft reperfusion. Dual hypothermic oxygenated machine perfusion (DHOPE) reduces ischemia/reperfusion injury and improves graft function, compared to conventional static cold storage (SCS). We examined the effect of DHOPE on ex situ and in vivo shifts of potassium and sodium. Potassium and sodium shifts were derived from balance measurements in a preclinical study of livers that underwent DHOPE (n = 6) or SCS alone (n = 9), followed by ex situ normothermic reperfusion. Similar measurements were performed in a clinical study of DHOPE-preserved livers (n = 10) and control livers that were transplanted after SCS only (n = 9). During DHOPE, preclinical and clinical livers released a mean of 17 +/- 2 and 34 +/- 6 mmol potassium and took up 25 +/- 9 and 24 +/- 14 mmol sodium, respectively. After subsequent normothermic reperfusion, DHOPE-preserved livers took up a mean of 19 +/- 3 mmol potassium, while controls released 8 +/- 5 mmol potassium. During liver transplantation, blood potassium levels decreased upon reperfusion of DHOPE-preserved livers while levels increased after reperfusion of SCS-preserved liver, delta potassium levels were -0.77 +/- 0.20 vs. +0.64 +/- 0.37 mmol/L, respectively (P = .002). While hyperkalemia is generally anticipated during transplantation of SCS-preserved livers, reperfusion of hypothermic machine perfused livers can lead to decreased blood potassium or even hypokalemia in the recipient. |
| Databáze: | OpenAIRE |
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