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β‐Galactosidase as a marker of ischemic injury and a mechanism for viability assessment in porcine liver transplantation
Author(s) -
St. Peter Shawn D.,
Imber Charles J.,
De Cenarruzabeitia Inigo Lopez,
Mcguire James,
James Tim,
Taylor Richard,
Friend Peter J.
Publication year - 2002
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1053/jlts.2002.30344
Subject(s) - medicine , liver transplantation , reperfusion injury , liver injury , ischemia , andrology , liver function , transplantation , cold storage , alanine transaminase , transaminase , hepatocyte , aspartate transaminase , extracorporeal , surgery , enzyme , biochemistry , biology , in vitro , alkaline phosphatase , horticulture
Glycohydrolases are a group of enzymes contained predominantly within lysosomes, which are released during Kupffer cell activation or death. One of these, β‐galactosidase, has been proposed as a marker of ischemia‐reperfusion injury in the liver because Kupffer cell activation represents a primary event in the injurious reperfusion cascade. In this study, we compared B‐galactosidase with more traditional indicators of liver injury and function in a porcine model of liver preservation. Porcine livers were allocated into two groups: group C (n = 5), preserved in University of Wisconsin solution by standard cold storage for 24 hours, and group W (n = 5), perfused with oxygenated autologous blood on an extracorporeal circuit for 24 hours. Both groups were subsequently tested on the circuit during a 24‐hour reperfusion phase. The perfusate was sampled for levels of β‐galactosidase, as well as traditional markers of liver injury and function. A sharp increase in β‐galactosidase levels was seen on reperfusion of cold preserved livers to a level of 1,900 IU/mL. This contrasted dramatically with normothermically preserved livers, in which the level never exceeded 208 IU/mL ( P = .002). β‐Galactosidase levels showed much earlier and greater increases compared with transaminase levels in livers injured by ischemia. A rapid elevation in β‐galactosidase levels corresponded well with poor liver function and more liver injury. Measurement of β‐galactosidase is a simple test that quantifies ischemia‐reperfusion injury of preserved livers. It is more sensitive than transaminases, with faster and larger increases in levels after ischemic injury. It can be useful in assessing the viability of a liver during machine preservation.