Assessment of hepatic ischaemia reperfusion injury by measuring intracellular tissue oxygenation using near infrared spectroscopy

Authors

  • Abd El-Hamid El-Desoky,

    1. University Department of Surgery and Liver Transplant Unit, Royal Free and University College Medical School, University College London, The Royal Free Hospital and Department of Medical Physics and Bioengineering, University College London, London, UK
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  • David T. Delpy,

    1. University Department of Surgery and Liver Transplant Unit, Royal Free and University College Medical School, University College London, The Royal Free Hospital and Department of Medical Physics and Bioengineering, University College London, London, UK
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  • Brian R. Davidson,

    1. University Department of Surgery and Liver Transplant Unit, Royal Free and University College Medical School, University College London, The Royal Free Hospital and Department of Medical Physics and Bioengineering, University College London, London, UK
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  • Alexander M. Seifalian

    1. University Department of Surgery and Liver Transplant Unit, Royal Free and University College Medical School, University College London, The Royal Free Hospital and Department of Medical Physics and Bioengineering, University College London, London, UK
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Dr Alexander M. Seifalian, Senior Lecturer in Biophysics & Haemodynamics, University Department of Surgery and Liver Transplant Unit, Royal Free and University College Medical School, University College London, The Royal Free Hospital, Pond Street, Hampstead, London NW3 2QG, UK. Tel: 020 7830 2901 (direct) or 020 7794 0500 Ext. 3936. Fax: 020 7431 4528. e-mail: a.seifalian@rfc.ucl.ac.uk

Abstract

Abstract:Aims/Background: Hepatic ischaemia/reperfusion (I/R) injury is a major cause of liver damage during liver surgery and transplantation. The relationship between the severity of I/R injury and the degree of intracellular hypoxia has not been investigated. Methods: New Zealand white rabbits were used in 4 groups (n=6 each). At laparotomy, left lobe hepatic ischaemia was produced for 30, 45, or 60 min followed by 60 min reperfusion and compared with controls. Liver function, bile flow, and flow in the hepatic microcirculation (HM) were measured. Near infrared spectroscopy (NIRS) was used to monitor hepatic oxyhaemoglobin (HbO2), deoxyhaemoglobin (Hb), and cytochrome oxidase (Cyt Ox). Results: I/R injury produced deranged liver function tests, reduced bile flow, and reduced flow in the microcirculation in comparison with controls. During ischaemia, HbO2 and Cyt Ox were significantly reduced in comparison with controls. After reperfusion, a biphasic change in tissue oxygenation was observed, with an initial increase in HbO2 and Cyt Ox followed by a progressive reduction. The reduction in tissue oxygenation with ischaemia and reperfusion paralleled the ischaemia time. After I/R, the changes in Cyt Ox (intracellular oxygenation) significantly correlated with the parameters of hepatocellular injury to a higher degree than HbO2 (extracellular oxygenation). Conclusion: This study shows the potential of monitoring the degree of I/R injury by measuring hepatic tissue intracellular oxygenation.

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