Improving the function of liver grafts exposed to warm ischemia by the leuven drug protocol: Exploring the molecular basis by microarray

✍ Scribed by Katrien Vekemans; Diethard Monbaliu; Erika Balligand; Veerle Heedfeld; Ina Jochmans; Jacques Pirenne; Jos van Pelt

• Publisher: John Wiley and Sons
• Year: 2012
• Tongue: English
• Weight: 314 KB
• Volume: 18
• Category: Article
• ISSN: 1527-6465
• DOI: 10.1002/lt.22446

✦ Synopsis

Livers exposed to warm ischemia (WI) before transplantation are at risk for primary nonfunction (PNF), graft dysfunction, and ischemic biliary strictures, all associated with ischemia/reperfusion injury (IRI). Our multifactorial approach, Leuven drug protocol (LDP), has been shown to reduce these effects and increase recipient survival in WI/IRI-damaged porcine liver transplantation. The aim was the identification of the molecular mechanisms responsible for the hepatoprotective effects of the LDP. Porcine livers were exposed to 45 minutes of WI, cold-stored for 4 hours, transplanted, and either modulated (LDP group; n ¼ 3) or not modulated (control group; n ¼ 4). In the LDP group, the donor livers were flushed with streptokinase and epoprostenol before cold perfusion; the recipients received intravenous glycine, a-1-acid-glycoprotein, FR167653 (a mitogen-activated protein kinase inhibitor), a-tocopherol, glutathione, and apotransferrin. Liver samples were taken before WI and 1 hour after reperfusion. Gene expression was determined with microarrays and molecular pathways and key regulatory genes were identified. The number of genes changed between baseline and 1 hour after reperfusion was 686 in the LDP group and 325 in the control group. The extra genes in the LDP group belonged predominantly to pathways related to cytokine activity, apoptosis, and cell proliferation. We identified 7 genes that were suppressed in the LDP group. These genes could be linked in part to the administered drugs. New potential drug targets were identified on the basis of genes induced in the control group but unaffected in the LDP group and interactions predicted by the literature. In Additional Supporting Information may be found in the online version of this article.

Abbreviations: AST, aspartate aminotransferase; CCL2, chemokine (C-C motif) ligand 2; CEBPB, CCAAT/enhancer-binding protein b; COX2, cyclooxygenase 2; CSF1, colony-stimulating factor 1; CXCL2, chemokine (C-X-C motif) ligand 2; DCD, donation after cardiac death; DUSP1, dual specificity protein phosphatase 1; EGR1, early growth response protein 1; FC, fold change; FOS, FBJ murine osteosarcoma viral oncogene homolog; GenMAPP,