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Arterial ketone index in assessing liver function and its detoxicative capability after ischemia-reperfusion injury.

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Caban A., Wiaderkiewicz R., Kamiński M., Oczkowicz G., Ziaja J.

2000

vol. 47

issue 4

1137-1146

Arterial ketone index (AKBR) which is the ratio of acetoacetic acid to 3-hydroxybutyric acid in the arterial blood, is believed to reflect the mitochondrial reduction potential of hepatocytes and general energy state of the liver. In the presented paper we challenged this hypothesis by analysing the correlation between AKBR and the results of typical liver blood tests (AspAT, AlAT, LDH, CRP) and biotransforming potential of the liver (cytochromes P450, b5 and their corresponding NADPH and NADH reductases) in the model of ischemia-reperfusion injury of rat liver. The results were compared with histochemical analysis of distribution and activity of SDH, LDH and G-6-Pase, the key marker enzymes of the liver. We have shown that, except in the case of acute phase protein (CRP), a decrease in AKBR correlated well with the increase of the level of indicator enzymes in serum. Histochemical analysis also confirmed that AKBR correlates with the degree of damage to hepatocytes during early stage of reperfusion after 60 min of liver ischemia. In the Spearman test, AKBR was significantly correlated with the changes in cytochrome P450 content and its NADPH reductase activity which indicates a high sensitivity of this test. We conclude that the decrease of AKBR value reflects the impairment of basic energy pathways and detoxicative capability of the liver.

Introduction of Liver Transplant Programme in Upper Silesia

52%

Król R., Jaworska K., Karkoszka H., Chudek J., Ziaja J., Badura J., Pawlicki J., Oczkowicz G., Caban A., Marcinkowski W., Sekta S., Wilk J., Gabriel A., Gonciarz Z., Kunsdorf-Wnuk A., Kokot F., Więcek A., Cierpka L.

Polish Journal of Surgery

2007

vol. 79

issue 10

656-662

Liver transplantation is the only method of treatment of patients with end stage liver insufficiency. Inadequate number of transplantations in Poland in relation to demands causes a need of new liver transplantation centres formation.The aim of the study was to present process of introduction of liver transplantation programme and results of the first 12 transplantations.Material and methods. Preparations to transplantation were based on training of surgical, anaesthetics and nephrological teams in transplant centres in Paris, Birmingham and Warsaw. Own protocols of organ harvesting, recipients' qualification, transplantation and postoperative treatment were worked out; they were a result of experience acquired in teaching centres. From October 16, 2005 to October 2006, 12 liver transplantations were performed in patients with end stage liver insufficiency of different origin. Patients' age varied from 21 to 67 years. The stage of liver failure according to Child-Pough was 8.6±2.8, and MELD 18.6±7.2. All elective operations were performed using Piggyback technique. Immunosuppression regimen was uniform and consisted of tacrolimus and prednisolone.Results. One patient died due to post reperfusion syndrome with no respond to catecholamine treatment. In 1 patient developed primary lack of the liver graft function that required re-transplantation, which was successfully performed on 2nd postoperative day. Among 10 patients who were discharged from the hospital on mean 31 postoperative day all are alive, and 7 of them returned to full live activity.Conclusion. Training in famous liver transplant centres and own experience in kidney and pancreas transplantation allowed for successful introduction of liver transplantation programme.

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1 Acta Biochimica Polonica

1 Polish Journal of Surgery

1 2007

1 2000

2 Caban A.

2 Oczkowicz G.

2 Ziaja J.

1 Badura J.

1 Chudek J.

1 Cierpka L.

1 Gabriel A.

1 Gonciarz Z.

1 Jaworska K.

1 Kamiński M.

1 Karkoszka H.

1 Kokot F.

1 Król R.

1 Kunsdorf-Wnuk A.

1 Marcinkowski W.

1 Pawlicki J.

1 Sekta S.

1 Wiaderkiewicz R.

1 Wilk J.

1 Więcek A.

Search results

Arterial ketone index in assessing liver function and its detoxicative capability after ischemia-reperfusion injury.

Introduction of Liver Transplant Programme in Upper Silesia