Increased exhaled carbon monoxide concentration during living donor liver transplantation

Takashi Matsusaki, Hiroshi Morimatsu, Toru Takahashi, Masaki Matsumi, Kenji Sato, Ryuji Kaku, Tetsufumi Sato, Takahito Yagi, Noriaki Tanaka, Kiyoshi Morita

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Exhaled carbon monoxide concentration (ExCO-C) has been reported to increase in oxidative tissue injuries such as systemic inflammation, and is thought to reflect increased heme breakdown in the affected organ. As a transplanted liver undergoes ischemia-reperfusion, we hypothesized that ExCO-C might also increase following liver transplantation and might serve as a measure of the severity of the graft tissue injury. We prospectively studied 67 living donor liver transplantation (LDLT) patients in a consecutive fashion. During anesthesia, ExCO-C was determined at 6 time points, ranging from anesthesia induction, to admission to the intensive care unit. We also measured two markers of endothelial cellular injury, i.e., serum soluble thrombomodulin (sTM) and intercellular adhesion molecule (ICAM)-1. At 5 min after reperfusion of the grafted liver, ExCO-C markedly increased from 5.69±2.34 ppm at baseline, to 9.79±4.72 ppm (p2=0.19, p=0.0003), and postoperative total bilirubin levels (day 1, 2, and 3; r 2=0. 102, 0.109 and 0.100; p=0.008, 0.007 and 0.010, respectively). Serum sTM and ICAM-1 levels were also significantly increased after reperfusion (sTM: 3.3±0.8 to 5.1±1.7 FU/ml, p=0.0001; ICAM-1: 271.9±86.3 to 515.0±157.8 FU/ml, p=0.0001). ExCO-C had a positive relationship with sTM (r2=0.16, p=0.035) and ICAM-1 (e=0.12, p=0.08). There was, however, no correlation of ExCO-C with serum AST/ALT levels or clinical outcomes. This study demonstrated that ExCO-C significantly increased after reperfusion during LDLT. The increased ExCO-C may likely reflect increased heme breakdown and endothelial cell injury in the grafted liver.

Original languageEnglish
Pages (from-to)75-81
Number of pages7
JournalInternational Journal of Molecular Medicine
Volume21
Issue number1
Publication statusPublished - Jan 2008

Fingerprint

Living Donors
Carbon Monoxide
Liver Transplantation
Thrombomodulin
Intercellular Adhesion Molecule-1
Reperfusion
Wounds and Injuries
Heme
Liver
Anesthesia
Serum
Bilirubin
Intensive Care Units
Ischemia
Endothelial Cells
Inflammation
Transplants

Keywords

  • Bilirubin IXα
  • Carboxyhemoglobin
  • Endothelial cell injury
  • Heme oxygenase
  • Ischemia-reperfusion

ASJC Scopus subject areas

  • Genetics

Cite this

Increased exhaled carbon monoxide concentration during living donor liver transplantation. / Matsusaki, Takashi; Morimatsu, Hiroshi; Takahashi, Toru; Matsumi, Masaki; Sato, Kenji; Kaku, Ryuji; Sato, Tetsufumi; Yagi, Takahito; Tanaka, Noriaki; Morita, Kiyoshi.

In: International Journal of Molecular Medicine, Vol. 21, No. 1, 01.2008, p. 75-81.

Research output: Contribution to journalArticle

Matsusaki, Takashi ; Morimatsu, Hiroshi ; Takahashi, Toru ; Matsumi, Masaki ; Sato, Kenji ; Kaku, Ryuji ; Sato, Tetsufumi ; Yagi, Takahito ; Tanaka, Noriaki ; Morita, Kiyoshi. / Increased exhaled carbon monoxide concentration during living donor liver transplantation. In: International Journal of Molecular Medicine. 2008 ; Vol. 21, No. 1. pp. 75-81.
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AU - Kaku, Ryuji

AU - Sato, Tetsufumi

AU - Yagi, Takahito

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