Metabolic Changes in the Pigliver During Warm Ischemia and Reperfusion Measured by Microdialysis
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Portal triad clamping can cause ischemia–reperfusion injury. The aim of the study was to monitor metabolic changes by microdialysis before, during, and after warm ischemia in the pigliver.
Material and Methods
Eight pigs underwent laparotomy followed by ischemia by Pringle’s maneuver. One microdialysis catheter was placed in each of four liver lobes. A reference catheter was placed in a muscle. Microdialysis samples were collected at intervals of 30 min starting 2 h before 1 h of total ischemia followed by 3 h of reperfusion. Glucose, lactate, pyruvate, and glycerol concentrations were measured. Blood samples were drawn for determination of alanine aminotransferase, alkaline phosphatase, and bilirubin together with total leukocytes and prothrombin time.
All parameters were stable during the baseline period. During the ischemic period, lactate levels increased significantly (P < 0.05) followed by a rapid decrease after reperfusion. A transient increase was observed for glucose and glycerol. Pyruvate showed a slight increase from the time of ischemia. The lactate–pyruvate ratio increased rapidly after initiating ischemia and decreased immediately after reperfusion. A slight increase in transaminase levels was observed.
During and after warm ischemia, there were profound metabolic changes in the pigliver observed with an increase in lactate, glucose, glycerol, and the lactate–pyruvate ratio. There were no differences between the four liver lobes, indicating the piglivers homogeneity.
KeywordsWarm liver ischemia Portal triad clamping Reperfusion Microdialysis Metabolic changes