Hepatic energy booster effect and lipo-modulatory effect on postreperfusional endotoxemia by intraoperative lipid infusion in porcine liver transplantation

We investigated whether intraoperative infusion of fat emulsion could suppr ess postoperative endotoxemia and improve energy status in the transplanted liver graft using a swine orthotopic liver transplantation (OLT) model. In traoperative free fatty acid (FFA) concentration, hepatic FFA clearance, se rum hyaluronic acid levers, ATP content and hepatic energy charge (HEC) in liver grafts. postreperfusional endotoxin levels and recipient outcome were compared between a fat emulsion-treated group (LCT-treated group, n = 6) a nd a saline infused-group (control group, n = 7). independent of massive su rgical stress and administration of heparin, FFA concentration was signific antly elevated in the LCT-treated group (P = 0.003). Since FFA clearance, A TP contents and HEC were also increased in the LCT-treated group (P = 0.024 , 0.006, 0.005, respectively), intraoperative LCT-treated nt was shown to i ncrease FFA concentration and improve energy status of liver grafts. Becaus e there were no significant differences in postoperative hyaluronic acid le vels, infused fat emulsion (0.1 g/kg per hour) prevented endothelial cell i njury. Significant improvement of postoperative endotoxemia was obtained at 1 and 2 h after reperfusion (P = 0.01 and 0.003, respectively). Energy boo ster effect and antiseptic effect led to prolonged survival of recipients i n the LCT-treated group (28.5 +/- 13.3 days, P = 0.013 vs, control). We con cluded that the hepatic energy booster effect and the lipo-modulatory effec t on postreperfusional endotoxemia caused by intraoperative infusion of fat emulsion may be of great use in human liver transplantation. (C) 2000 Else vier Science Ireland Ltd. All rights reserved.