Surgical Denervation Influence on Hepatocellular Oxidative Stress in Brain Death and Living Donors*

Octavian Bud1,2, M. Golling1, H. Kellner2, Th. Kraus1, M.M. Gebhard2, Christian Herfarth1 and E. Klar1

Abstract


Aim of the study. Liver function following brain death (BD) is mainly influenced via central action of sympathetic nerves and changes in systemic and portal perfusion. We examined the specific influence of surgical denervation on the intrahepatic oxidative stress (reduced [rGSHL] and oxidised [GSSGL] glutathione) in cardiocirculatory stable BD animals compared to living donors [LD] in a porcine model.

Methods
. BD (n=8) was induced via continuous NaCl inflation of an epidurally placed Tieman-catheter (1 mL/5 min) and compared to the control group (n=6) of living donors. Measurements of the hepatic microperfusion (thermodif-fusion probe: ml/100g/min), and the glutathione [rGSHL, GSSGL ; nmol/mg protein] were performed 2 h following BD and 2 h following denervation of the liver. For statistical analysis the Wilcoxon and Mann-Witney U-Test was used. Overall significance was set at p<0.05.

Results
. In comparison with LD, BD animals showed a reduced rGSHL (19±1.5 [BD] vs. 32±1 [LD]; p<0.01]; GSSGL (1.7±0.4 [BD] vs. 0.7±0.5 [LD]; p<0.01) and a severe reduced redox potential (GSHL/GSSGL: 11.5±1.0[BD] vs. 43.1±0.08[LD]; p<0.001). Surgical denervation resulted in reduction of oxidative stress in the BD group [BD: rGSHL:31±1 (p<0.01); GSSGL:0.96±0.02 (p<0.05); GSHL/GSSGL:31.3±0.006 (p<0.01)] while it increased in the living donors [LD: rGSHL:15±0.7 (p<0.01); GSSGL: 1.1 ± 0.02 (p<0.05); GSHL/GSSGL: 13.8±0.05 (p<0.01)].

Conclusion
. Intrahepatic oxidative stress is increased in cardiocirculatory stable BD animals compared with LD. Surgical denervation of the liver will reduce the oxidative stress only in BD animals while it increases in living donors.
The results imply a potential benefit of surgical denervation of the liver before explantation in BD donors only.

Key words


Liver transplantation - oxidative stress _ brain death _ living donors