PREDICTING THE VIABILITY OF GRAFTED LIVERS IN RATS THROUGH A RAPID AND SENSITIVE METABOLIC INDICATOR ASSESSED BY P-31-NMR SPECTROSCOPY

The present study was undertaken to clarify whether a correlation exis ts between the hepatic ratio of the beta-phosphorus moiety of ATP (B-A TP) to inorganic phosphate (Pi), measured by P-31 nuclear magnetic res onance spectroscopy 1 h after the reestablishment of portal blood flow , and the survival rate of rats following liver transplantation. This ratio was compared with the arterial ketone body ratio [AKBR (acetoace tate/3-hydroxybutyrate)], which is accepted as a reliable indicator of liver viability. After the transplantation of fresh livers, the 1-wee k survival rate was 92% and the beta-ATP/Pi ratio was 64% of the norma l level. When the liver grafts were subjected to warm ischemia for 25 min or 45 min prior to harvesting, the 1-week survival rate decreased to 43% and 0%, respectively, and the beta-ATP/Pi ratio dropped to 31% and 18% of the normal level, respectively. On the other hand, the AKBR was about 25% of the normal level after transplantation of fresh live rs, while it was 37% and 48% after transplantation with 25 min and 45 min of warm ischemia, respectively. However, 4 h after the reestablish ment of portal blood flow, the AKBR correlated with the beta-ATP/Pi ra tio in both the fresh graft group and the 45-min warm ischemic damage group. These results show that the beta-ATP/Pi ratio provides an accur ate evaluation of a graft viability even at an extremely early stage f ollowing liver transplantation, and should prove useful for the early diagnosis of primary graft nonfunction after liver transplantation.