Reducing the size of a liver for use in a recipient smaller than the donor is one way to reduce mortality before orthotopic liver transplantation in children because of the scarcity of pediatric organ donors. In this report., we review the results of this approach over the past 2 years, during which
Effect of angiotensin II and bradykinin inhibition in rat reduced-size liver transplantation
✍ Scribed by Susagna Padrissa-Altés; Rosa Franco-Gou; Olivier Boillot; Anna Serafín; Antoni Rimola; Vicente Arroyo; Joan Rodés; Carmen Peralta; Joan Roselló-Catafau
- Publisher
- John Wiley and Sons
- Year
- 2009
- Tongue
- English
- Weight
- 310 KB
- Volume
- 15
- Category
- Article
- ISSN
- 1527-6465
- DOI
- 10.1002/lt.21693
No coin nor oath required. For personal study only.
✦ Synopsis
This study examined whether angiotensin II (Ang II) blockers [Ang II type I receptor antagonist, Ang II type II receptor antagonist, and angiotensin converting enzyme (ACE) inhibitor] could reduce hepatic injury and improve regeneration in reduced-size orthotopic liver transplantation (ROLT) and whether the beneficial effects of ischemic preconditioning (PC) in ROLT could be explained by changes in Ang II. We show that small liver grafts generated Ang II after ROLT and that this was associated with increased angiotensinogen and ACE messenger RNA expression. Furthermore, inhibition of Ang II did not contribute to PC-induced protection in ROLT. All Ang II blockers reduced hepatic injury, but none of them promoted liver regeneration. Bradykinin (BK) receptor antagonist improved liver regeneration but did not reduce hepatic injury in ROLT. Finally, the combination of Ang II blockers and BK receptor antagonists in ROLT reduced hepatic injury and improved liver regeneration. In conclusion, treatments with either Ang II blockers or BK receptor antagonists cannot, on their own, improve the outcome of ROLT. Although Ang II blockers can reduce hepatic ischemia-reperfusion injury and BK receptor antagonists can promote liver regeneration, neither confers both benefits at the same time. Consequently, it may be of clinical interest to apply both treatments simultaneously.
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