NONINVASIVE METABOLIC ASSESSMENT OF HUMAN DONOR LIVERS - PROGNOSTIC VALUE OF P-31-MAGNETIC RESONANCE SPECTROSCOPY FOR EARLY GRAFT FUNCTION

Background. The purpose of this study was to investigate whether phosp horus-31 magnetic resonance spectroscopy (P-31-MRS) of the isolated do nor liver can serve as a viability indicator with prognostic value for transplantation outcome. Methods. Forty human donor livers preserved with University of Wisconsin solution were studied shortly before tran splantation. The respective spectral peak areas of the isolated donor liver were correlated with the amount of hepatocellular graft damage a nd liver metabolic function shortly after implantation. Results. The i ndividual phosphomonoesters, inorganic phosphate, phosphodiesters, and nicotine adenine dinucleotide peaks were not prognostic for postopera tive hepatocellular damage or liver metabolic capacity. The presence o f adenosine triphosphate, however, predicts a significantly better met abolic capacity to eliminate bilirubin, to synthesize fibrinogen and a ntithrombin III, and to maintain a better prothrombin time after trans plantation. Furthermore, this study is probably the first P-31-MRS dem onstration in the human liver of phosphocreatine, Conclusions. In the clinical setting described, metabolic assessment using P-31-MRS did no t result in a reliable noninvasive test to predict primary graft dysfu nction. Study of the role of phosphocreatine in liver metabolism durin g cold storage is needed.