Duke University Medical Center investigators think they have found a way to preserve livers longer prior to transplantation and minimize the possibility of injury.
The findings were based on the researchers’ observations that donor livers awaiting transplant undergo changes that are similar to the early stages of tumor growth.
To investigate if the damage that occurs to the livers during cold preservation is caused by the activation of angiogenic mechanisms, the investigators pretreated rat livers with three antiangiogenic agents: minocycline, interferon alpha, and fumagillin. While sinusoidal lining cell integrity and viability were significantly improved in all of the treated livers and reperfusion injury and survival also were improved, the effect was most striking in the livers treated with interferon alpha.
"We provide data suggesting that angiogenic factors are produced during cold preservation and may play an important role in the pathogenesis of sinusoidal lining cell injury during the period of cold preservation," Pierre-Alain Clavien, MD, PhD, and colleagues reported in the November issues of Gastroenterology (1997;113:1692-1700). The findings, they continued, "open the door for improved preservation strategies."
Because peak levels of interferon alpha occurred two to six hours after injection, a single dose a few hours before organ recovery and addition of the drug in the preservation solution might be able to dramatically prevent injuries to the liver, Dr. Clavien reported.
For Your Information:
Pierre-Alain Clavien, MD, PhD
Section of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery
Duke University Medical Center
Bell Building Room 102, Durham, NC 27710
clavi001@mc.duke.edu
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