DIRECT INDUCTION OF ACUTE LUNG AND MYOCARDIAL DYSFUNCTION BY LIVER ISCHEMIA AND REPERFUSION

Objectives: To investigate whether liver ischemia and reperfusion (IR) directly affect functions of remote organs. Background: Cardiovascula r and respiratory dysfunction follows hemorrhage, spinal shock, or tra uma as a result of no-flow-reflow phenomena, Hepatic IR induces remote organ damage probably by xanthine oxidase and oxygen species. Materia ls and Methods: Isolated rat livers, lungs, and hearts were perfused w ith Krebs-Henseleit solutions. After stabilization, livers were either perfused or made ischemic. Then, livers and hearts or livers and lung s were reperfused in series, and the liver was disconnected and the se cond organ continued to perfuse with the accumulated effluents. Measur ements and Main Results: Ischemic and reperfused liver effluent contai ned high lactate dehydrogenase and uric acid concentrations compared w ith controls; xanthine oxidase increased 60 to 100 times. Ischemic and reperfused lung peak inspiratory pressure almost doubled; airway stat ic compliance halved; myocardial contractility decreased to 70% of bas eline; wet weight-to-dry weight ratios of lungs and livers increased. Conclusion: Ischemic and reperfused liver can directly induce myocardi al and pulmonary dysfunction, presumably by oxidant-induced injury.