Graft function and survival depend primarily on host factors in compromised recipient models of orthotopic liver transplantation in the rat

Background. Experimental models of liver transplantation use normal recipie nts, although most patients undergoing liver transplantation suffer from ac ute or chronic liver failure. This study was designed 60 analyze the outcom e of orthotopic liver transplantation in compromised rat hosts, Methods. Recipient animals were either rats with D-galactosamine-induced ac ute or rats with chronic liver failure secondary to common bile duct ligati on. Liver damage was evaluated by monitoring enzymes, bilirubin, ammonia le vels, prothrombin, thrombin time, and cytokines, In vivo function of hepato cytes and sinusoidal endothelial cells were evaluated by indocyanine green and hyaluronic acid uptake, Transplantation was performed in normal, acute, and chronic liver failure rats at different time points using either fresh ly harvested or cold-preserved syngeneic livers. Results. Survival with fresh grafts decreased significantly when transplant s were performed 48 hr after the induction of acute liver failure. No rats with acute liver failure survived transplantation with grafts stored for 12 or 24 hr although in chronic failure survival was more 80%. Survival of ac ute liver failure rats receiving 6 hr preserved grafts was 16.6% compared w ith 83.3% observed with fresh grafts transplanted at the same time point af ter D-galactosamine injection. Elevated tumor necrosis factor-alpha and int erleukin-1 beta levels as well as impaired sinusoidal endothelial cell func tion were detected in acute Liver failure rats with 6 h preserved grafts. Conclusion, These results suggest that preoperative status and different ho st factors have a significant effect on outcome and graft function after li ves transplantation in rats.