Impact of endotoxin measured by an endotoxin activity assay during liver transplantation

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• 作者：Yukihiro Sanada ; MD^a ; ^{yuki371@jichi.ac.jp} ; Koichi Mizuta ; MD ; PhD^a ; Taizen Urahashi ; MD ; PhD^a ; Yoshiyuki Ihara ; MD ; PhD^a ; Taiichi Wakiya ; MD^a ; Noriki Okada ; MD^a ; Naoya Yamada ; MD^a ; Kentaro Ushijima ; PhD^b ; Shinya Otomo^c ; Koichi Sakamoto ; PhD^c ; Yoshikazu Yasuda ; MD ; PhD^d ; Hideo Kawarasaki ; MD ; PhD^a
• 关键词：Endotoxin activity assay ; Endotoxin ; Infection ; Acute rejection ; Liver transplantation
• 刊名：Journal of Surgical Research
• 出版年：2013
• 出版时间：April, 2013
• 年：2013
• 卷：180
• 期：2
• 页码：349-355
• 全文大小：454 K

文摘

Background

Endotoxin (Et) in the portal vein blood is processed by the hepatic reticuloendothelial system. Thus, it is possible that the Et kinetics of the peripheral venous blood may be useful as a biological index that can be used to evaluate liver function. In this study, we measured Et using the endotoxin activity assay in peripheral venous blood during living donor liver transplantation (LDLT), to study its clinical significance.

Methods

Subjects were 17 patients who underwent LDLT. In the perioperative peripheral venous blood, was measured Et activity (EA) using the endotoxin activity assay at 1 or 2?d before LT, and then on 1, 5, 7, 14, and 21 postoperative days.

Results

Patients with infections had significantly higher EA levels compared with those without complications before LDLT and 14 postoperative days (P = 0.038 and 0.027, respectively). The average EA level of patients with infections and without complications before LT was 0.22 and 0.08, respectively (P = 0.038). Patients with an EA level higher than 0.20 before LDLT had a significantly longer period of hospitalization compared with those without complications (P = 0.038).

Conclusions

A preoperative EA level more than 0.20 is a high risk factor for post-transplant infection and a prolonged period of hospitalization.