Metabolic changes in the pig liver during warm ischemia and reperfusion measured by microdialysis

Abstract

Aim: 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.

Results: 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.

Conclusions: 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.