Einfluss diverser Reperfusionsarten auf den Ischämie-/Reperfusionsschaden nach orthotoper Lebertransplantation im Rattenmodell

Introduction: graft dysfunction after liver transplantation due to ischemia-/reperfusion injury remains a serious clinical problem although there is a marked progress in transplantation medicine. The aim of this experimental study was to compare different types of reperfusion with regard to the ischemia-/reperfusion injury. Materials and Methods: arterialised orthotopic liver transplantation (OLT) was performed in syngenic male Lewis rats. The animals were devided into 3 experimental groups: I- and II-control groups with antegrade reperfusion, III-retrograde reperfusion group. Laboratory parameters as well as histopathologic changes of the graft were evaluated 1, 24 and 48 hours after the OLT. Results: 24 hours after the OLT the GOT-values showed a significant difference between groups with antegrade/retrograde variant of reperfusion (2613,3 ± 343,9 U/l vs. 1186,4 ± 252,9 U/l; p < 0,001). The GPT- and GOT-values were significanly lower in the group III 48 hours after OLT. The histopathologic evaluation revealed a significantly lower number of necrotic areas in the group III compared to the control-groups (p < 0,002). Conclusion: our results show that the retrograde reperfusion (from the infrahepatic V. cava inferior with opening of the blood stream to the supra-hepatic V. cava inferior and to the Vv. hepaticae retrograde to the liver) has a protective effect on the graft.