HEPATIC PROTEIN-SYNTHESIS RATE OF LIVER SPECIMENS AS A PREDICTOR OF VIABILITY IN RAT COLD ISCHEMIA LIVER-TRANSPLANTATION MODEL

Background/Aims: We have previously reported that the hepatic protein synthesis rate, calculated as the uptake rate of L-[4.5 H-3] leucine b y the protein fraction during a 10-min incubation of a 16-G needle bio psy specimen of liver tissue, represents a high level of liver functio n and is therefore useful for evaluating liver function. We investigat ed the hepatic protein synthesis rate level in a pretransplant liver t o learn if it might predict the outcome in a rat orthotopic liver tran splantation model. Methods: Grafts were stored, liver specimens were o btained using a 21-G Chiba type II skinny needle, and the hepatic prot ein synthesis rate was calculated. Subsequently, liver transplantation was performed, and the hepatic protein synthesis rate level of revasc ularized liver, tissue blood flow rate, serum alanine aminotransferase , lactate dehydrogenase, hyaluronic acid, ketone body rate, and 2-week survival were examined, Results: The hepatic protein synthesis rate o f pretransplant liver was correlated with parameters of post-transplan t liver function: hepatic protein synthesis rate of the revascularized liver (r=0.92, p<0.0001), tissue blood flow rate (r=0.77, p<0.004), s erum alanine aminotransferase (r=-0.69, p<0.003), lactate dehydrogenas e (r=-0.54, p<0.03), hyaluronic acid (r=-0.86, p<0.0002), and ketone b ody rate (r= 0.57, p<0.02). Pretransplant hepatic protein synthesis ra te in survivors was 263.6+/-54.2 nmol/mg protein/10 min, while that in nonsurvivors was significantly lower at 162.0+/-39.0 (p<0.0001). When evaluation was made using a logistic regression model, the accuracy p redicted using the value of hepatic protein synthesis rate was 95% (19 /20). Conclusions: These results suggest that measuring the hepatic pr otein synthesis rate of the grafts with a 21-G Chiba type II skinny ne edle may be a predictive criterion in the assessment of graft viabilit y.