Selective bowel decontamination of recipients for prevention against liver injury following orthotopic liver transplantation: Evaluation with rat models

Gut‐derived substances can activate Kupffer cells to provoke hepatic necrosis after partial hepatectomy in rats. A similar situation may occur during orthotopic liver transplantation (OLT), as congestion in the intestinal wall, caused by portal vein occlusion, is inevitable during the operation. The contribution of such substances to liver injury following OLT was investigated in rats. Oral administration of polymyxin B sulfate for 7 days significantly altered intestinal bacterial flora in rats; Enterobacteriaceae diminished and anaerobes such as Bifidobacterium, Lactobacillus,Bacteroides, and Eubacterium increased in number, compared with the control rats. Also, this treatment significantly reduced endotoxin concentration in the portal blood 30 minutes after blood reflow following portal vein occlusion. When OLT was performed in rats using the liver preserved in cold University of Wisconsin solution for 18 hours, tissue factor activity in Kupffer cells (KC) isolated from the transplanted liver 1 hour after the operation was significantly higher than in that of normal rats. This increase was significantly reduced by pretreatment of the recipients with polymyxin B sulfate. In these recipients, serum alanine aminotransferase activity, tumor necrosis factor α (TNFα) concentration, and histological extent of liver necrosis were significantly attenuated at 24 hours after the operation compared with those of control rats. We conclude that the substances derived from bacilli sensitive to polymyxin B sulfate in the gut may be a contributing factor to liver injury following OLT in rats; we feel that this probably occurs by entering of the substances into the portal blood during the ahepatic phase of the operation to activate KC. Selective bowel decontamination of recipients with polymyxin B sulfate would be a candidate for protection against early graft failure following OLT.

[1]  K. Fujiwara,et al.  Bacterial translocation from gut to portal blood in the recipient as a factor of hypercoagulopathy in hepatic sinusoids after orthotopic liver transplantation in rats. , 1997, Transplantation proceedings.

[2]  K. Fujiwara,et al.  Blood coagulation in the hepatic sinusoids as a contributing factor in liver injury following orthotopic liver transplantation in the rat. , 1996, Transplantation.

[3]  I. Maruyama,et al.  Blood coagulation equilibrium in rat liver microcirculation as evaluated by endothelial cell thrombomodulin and macrophage tissue factor. , 1995, Thrombosis research.

[4]  K. Fujiwara,et al.  Role of adhesion between activated macrophages and endothelial cells in the development of two types of massive hepatic necrosis in rats , 1995, Journal of gastroenterology and hepatology.

[5]  T. Matsunaga,et al.  [Effects of azithromycin on fecal flora of healthy adult volunteers]. , 1995, The Japanese journal of antibiotics.

[6]  K. Fujiwara,et al.  Possible cause of primary graft non‐function after orthotopic liver transplantation: A hypothesis with rat models , 1995, Journal of gastroenterology and hepatology.

[7]  L. Bermudez,et al.  Effects of pentoxifylline pretreatment on Kupffer cells in rat liver transplantation , 1995, Hepatology.

[8]  T. Nakamura,et al.  Involvement of ICAM-1 expression on sinusoidal endothelial cell and neutrophil adherence in the reperfusion injury of cold-preserved livers. , 1995, Transplantation proceedings.

[9]  T. Kamei,et al.  Donor treatment with gadolinium chloride improves survival after transplantation of cold-stored livers by reducing Kupffer cell tumor necrosis factor production in rats. , 1995, Transplantation proceedings.

[10]  K. Fujiwara,et al.  Oxidative stress in hepatocytes and stimulatory state of Kupffer cells after reperfusion differ between warm and cold ischemia in rats. , 2008, Liver.

[11]  K. Fujiwara,et al.  Coagulability in the sinusoids of orthotopically transplanted livers in rats. , 1994, Transplantation proceedings.

[12]  C. Smith,et al.  Functional inactivation of neutrophils with a Mac‐1 (CD11b/CD18) monoclonal antibody protects against ischemia‐reperfusion injury in rat liver , 1993, Hepatology.

[13]  R. Porte,et al.  Intravascular Coagulation in Liver Transplantation – Is It Present or Not? , 1993, Thrombosis and Haemostasis.

[14]  H. Fusamoto,et al.  Tumor necrosis factor and endotoxin in the pathogenesis of liver and pulmonary injuries after orthotopic liver transplantation in the rat , 1992, Hepatology.

[15]  K. Fujiwara,et al.  Gut-derived substances in activation of hepatic macrophages after partial hepatectomy in rats. , 1992, Journal of hepatology.

[16]  T E Starzl,et al.  Cause and timing of first allograft failure in orthotopic liver transplantation: A study of 177 consecutive patients , 1991, Hepatology.

[17]  H. de Groot,et al.  O2-. release by activated Kupffer cells upon hypoxia-reoxygenation. , 1991, The American journal of physiology.

[18]  F. Lang,et al.  Inhibition of ion conductances by osmotic shrinkage of Madin-Darby canine kidney cells. , 1991, The American journal of physiology.

[19]  R. Wiesner.  Selective bowel decontamination for infection prophylaxis in liver transplantation patients. , 1991, Transplantation proceedings.

[20]  J. Horwitz,et al.  Evaluation of the electroinjection method for introducing proteins into living cells. , 1991, The American journal of physiology.

[21]  I. Marzi,et al.  Methyl palmitate prevents Kupffer cell activation and improves survival after orthotopic liver transplantation in the rat , 1991, Transplant international : official journal of the European Society for Organ Transplantation.

[22]  J. Lemasters,et al.  Kupffer cell activation and endothelial cell damage after storage of rat livers: Effects of reperfusion , 1991, Hepatology.

[23]  K. Fujiwara,et al.  Provocation of massive hepatic necrosis by endotoxin after partial hepatectomy in rats. , 1990, Gastroenterology.

[24]  W. Bechstein,et al.  Selective bowel decontamination effectively prevents gram-negative bacterial infections after liver transplantation. , 1990, Transplantation proceedings.

[25]  I. Marzi,et al.  INCREASE IN SURVIVAL TIME OF LIVER TRANSPLANTS BY PROTEASE INHIBITORS AND A CALCIUM CHANNEL BLOCKER, NISOLDIPINE , 1990, Transplantation.

[26]  R. Calne,et al.  Coagulation changes following hepatic revascularization during liver transplantation. , 1989, Transplantation.

[27]  T. Starzl,et al.  Endotoxemia and human liver transplantation. , 1989, Transplantation proceedings.

[28]  K. Fujiwara,et al.  In situ evaluation of the stimulatory state of hepatic macrophages based on their ability to produce superoxide anions in rats , 1989, The Journal of pathology.

[29]  R. Wiesner,et al.  The first 100 liver transplantations at the Mayo Clinic. , 1989, Mayo Clinic proceedings.

[30]  D. V. van Thiel,et al.  Liver transplantation: An overview , 1988, Hepatology.

[31]  J. Platt,et al.  Effect of T Cell Modulation on the Translocation of Bacteria from the Gut and Mesenteric Lymph Node , 1988, Annals of surgery.

[32]  R. Wiesner,et al.  SELECTIVE BOWEL DECONTAMINATION TO DECREASE GRAM‐NEGATIVE AEROBIC BACTERIAL AND CANDIDA COLONIZATION AND PREVENT INFECTION AFTER ORTHOTOPIC LIVER TRANSPLANTATION , 1988, Transplantation.

[33]  J. Hiatt,et al.  The First 100 Liver Transplants at UCLA , 1987, Annals of surgery.

[34]  嶋田 甚五郎,et al.  6315-S (Flomoxef) にかんする臨床的研究 , 1987 .

[35]  J. Weiel,et al.  Phorbol esters and calcium ionophore can prime murine peritoneal macrophages for tumor cell destruction. , 1986, Journal of immunology.

[36]  H. Tamura,et al.  A new chromogenic endotoxin-specific assay using recombined limulus coagulation enzymes and its clinical applications. , 1985, Clinica chimica acta; international journal of clinical chemistry.

[37]  A. Weintraub,et al.  Capsular polysaccharides and lipopolysaccharides from two Bacteroides fragilis reference strains: chemical and immunochemical characterization , 1983, Journal of bacteriology.

[38]  G. Mazzei,et al.  Polymyxin B is a more selective inhibitor for phospholipid-sensitive Ca2+-dependent protein kinase than for calmodulin-sensitive Ca2+-dependent protein kinase. , 1982, Biochemical and biophysical research communications.

[39]  E. Hische,et al.  Spectrophotometry of tissue thromboplastin in cerebrospinal fluid. , 1981, Clinical chemistry.

[40]  C. Ingoldby.  The value of polymixin B in endotoxaemia due to experimental obstructive jaundice and mesenteric ischaemia , 1980, The British journal of surgery.

[41]  T. Starzl,et al.  Fifteen years of clinical liver transplantation. , 1979, Gastroenterology.

[42]  R. Calne,et al.  ORTHOTOPIC LIVER TRANSPLANTATION IN THE RAT: TECHNIQUE USING CUFF FOR PORTAL VEIN ANASTOMOSIS AND BILIARY DRAINAGE , 1979, Transplantation.

[43]  H. Gans.  Effect of ligation of the hepatic artery or occlusion of the portal vein on the development of endotoxema. , 1974, Surgery, gynecology & obstetrics.

[44]  W. Craig,et al.  Prevention of the Generalized Shwartzman Reaction and Endotoxin Lethality by Polymyxin B Localized in Tissues , 1974, Infection and immunity.

[45]  R. Miller,et al.  Reticuloendothelial dysfunction and endotoxemia following protal vein occlusion. , 1974, Surgery.

[46]  W. Craig,et al.  Dynamics of binding and release of the polymyxin antibiotics by tissues. , 1973, The Journal of pharmacology and experimental therapeutics.

[47]  C. Kunin,et al.  Recovery of Tissue Bound Polymyxin B and Colistimethate 1 , 1971, Proceedings of the Society for Experimental Biology and Medicine. Society for Experimental Biology and Medicine.

[48]  J. Palmer,et al.  Neutralization of Endotoxin Toxicity in Chick Embryos by Antibiotics , 1966, Journal of bacteriology.

[49]  T. Starzl,et al.  Infectious diseases associated with renal homotransplantation: I. Incidence, types, and predisposing factors , 1964 .

[50]  B. A. Newton.  The properties and mode of action of the polymyxins. , 1956, Bacteriological reviews.