Expression And Role Of INOS In Early Injury Of Small Graft In Rat Liver Transplantation

Liver transplantation has become the only and most effectivetreatment with end-stage liver disease. With the rapid development of liver transplantation, the growing discrepancy between available cadaveric donors and liver transplant candidates, and associated increase in waiting time during the past years has led to an increasing percentage of patients advancing to the late stages of chronic liver failure and receiving transplants when they are much sicker. Appearance of living donor liver transplantation (LDLT) or living related liver transplantation (LRLT) and split liver transplantation (SLT) has lowered mortality rate during waiting time of child andadult patients with end-stage liver disease and provided a new way to cope with the serious shortage of cadaveric donors. With the advantage which cadaveric liver transplantation can't compare to, LDLT has already gradually applied to adult patients. The safety of the donor remains central to LDLT, which usually cause small volume of graft, thus make more complications of recipient and lower survival rates of graft/ recipient than whole liver transplantation. To improve the effect of partial liver transplantation, some efforts have been focused on reasons of dysfunction of small graft. Researches for years confirmed that ischemic reperfusion injury played an important role in dysfunction of graft of whole liver transplantation. Strategy targeting for ischemic reperfusion injury may be helpful to liver transplantation. Constitutive NO synthesis by eNOS in endothelial cells is protective, whereas centrilobular iNOS expression by inflammatory cells contributes to hepatic injury during ischemic reperfusion injury. This study on expression and role of iNOS in early injury of small graft in rat liver transplantation is on the base of eastablishment of small graft model in rat liver transplantation.Male Sprague-Dawley rats were divided randomly into three groups: sham group (control, group A, 8 rats), ischemia reperfusion group (group B, 30 rats); small graft group(group C, 30 rats). Changes of TB, ALT and AST in serum, MDA and SOD in liver tissue,pathology of liver and expression of iNOS in liver of three groups were compared. Results TB , ALT and AST of group A were lower significantly than these of group B and group C (P<0.05 ) . The peak of TB, ALT and AST was observed at 6h, then descended. The peak of TB, ALT and AST of group C were highest, and these of group A were lowest. MDA of group A was lower than other groups, MDA of group C was higher than group B (P<0.05) , the change of SOD was contrary to MDA. Pathology in light and electronic of group B and C were typical changes after ischemia reperfusion injury. Expression of iNOS after reperfusion of group B and C increased significantly and reached peak at 6h, and then descended. The level of iNOS at 12-24h was higher than control. The peak of iNOS of group C was significantly higher than group B.These results indicated that iNOS was involved actively in early injury of small graft in rat liver transplantation, free radical played an important role in ischemic reperfusion injury. This study sets a base of strategy targeting for iNOS which may alleviate ischemic reperfusion injury of small graft.