Brief Articles
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Jul 28, 2009; 15(28): 3538-3541
Published online Jul 28, 2009. doi: 10.3748/wjg.15.3538
Urokinase perfusion prevents intrahepatic ischemic-type biliary lesion in donor livers
Ren Lang, Qiang He, Zhong-Kui Jin, Dong-Dong Han, Da-Zhi Chen
Ren Lang, Qiang He, Zhong-Kui Jin, Dong-Dong Han, Da-Zhi Chen, Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing Center for Organ Transplantation, Beijing 100020, China
Author contributions: Lang R and Chen DZ designed research; Lang R, He Q, Jin ZK and Han DD performed research; Lang R and Chen DZ wrote the paper.
Correspondence to: Da-Zhi Chen, Professor, Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing Center for Organ Transplantation, Beijing 100020, China. chendazhi@medmail.com.cn
Telephone: +86-10-85231241
Fax: +86-10-85231503
Received: February 16, 2009
Revised: May 6, 2009
Accepted: May 13, 2009
Published online: July 28, 2009
Abstract

AIM: To evaluate whether urokinase perfusion of non-heart-beating cadaveric donor livers reduces the incidence of intrahepatic ischemic-type biliary lesions (IITBLs).

METHODS: A prospective study was conducted to investigate potential microthrombosis in biliary microcirculation when non-heart-beating cadaveric livers were under warm or cold ischemic conditions. The experimental group included 140 patients who underwent liver transplantation during the period of January 2006 to December 2007, and survived for more than 1 year. The control group included 220 patients who received liver transplantation between July 1999 and December 2005 and survived for more than 1 year. In the experimental group, the arterial system of the donor liver was perfused twice with urokinase during cold perfusion and after trimming of the donor liver. The incidence of IITBLs was compared between the two groups.

RESULTS: In the control group, the incidence of IITBLs was 5.9% (13/220 cases) after 3-11 mo of transplantation. In the experimental group, two recipients (1.4%) developed IITBLs at 3 and 6 mo after transplantation, respectively. The difference in the incidence between the two groups was statistically significant (P < 0.05).

CONCLUSION: Double perfusion of cadaveric livers from non-heart-beating donors with urokinase may reduce the incidence of IITBLs.

Keywords: Cadaver donor, Liver transplantation, Ischemic-type biliary lesion, Urokinase