Edaravone, a free radical scavenger, improves the graft viability on liver transplantation from non-heart-beating donors in pigs

Transplant Proc. 2014 May;46(4):1090-4. doi: 10.1016/j.transproceed.2013.11.155.

Abstract

Background: Although liver transplantation from non-heart-beating donors (NHBDs) is an effective way to overcome shortage of donors, primary graft nonfunction is often noted in these grafts. We have previously reported that edaravone, a free radical scavenger, has a cytoprotective effect on warm ischemia-reperfusion injury and improves the function of liver grafts from NHBDs in a rat model of ischemia-reperfusion. The purpose of this study was to investigate the effects of edaravone on liver transplantations from NHBDs.

Methods: Pigs were divided into three groups: (1) a heart-beating (HB) group (n = 5), in which liver grafts were retrieved from HB donors; (2) a non-heart-beating (NHB) group (n = 4), in which liver grafts were retrieved under apnea-induced NHB conditions; and (3) an edaravone-treated (ED) group (n = 5), in which liver grafts were retrieved in the same manner as the NHB group and treated with edaravone at the time of perfusion (3 mg/L in University of Wisconsin [UW] solution), cold preservation (1 mg/L in UW solution), and after surgery (1 mg/kg/d). The grafts from all groups were transplanted after 4 hours of cold preservation.

Results: In the ED group, the 7-day survival rate was significantly higher than that in the NHB group (80% versus 0%, P = .0042, Kaplan-Meier log-rank test). Furthermore, on histologic examination, the structure of sinusoids in the ED group was well preserved and similar to that in the HB group.

Conclusions: Edaravone may improve the viability of liver grafts from NHBDs.

MeSH terms

  • Adenosine / pharmacology
  • Allopurinol / pharmacology
  • Animals
  • Antipyrine / analogs & derivatives*
  • Antipyrine / pharmacology
  • Biomarkers / blood
  • Cold Ischemia
  • Cytoprotection
  • Edaravone
  • Free Radical Scavengers / pharmacology*
  • Glutathione / pharmacology
  • Graft Survival / drug effects*
  • Insulin / pharmacology
  • Liver / drug effects*
  • Liver / metabolism
  • Liver / pathology
  • Liver / surgery*
  • Liver Transplantation / adverse effects
  • Liver Transplantation / methods*
  • Male
  • Models, Animal
  • Organ Preservation Solutions / pharmacology
  • Raffinose / pharmacology
  • Reperfusion Injury / blood
  • Reperfusion Injury / diagnosis
  • Reperfusion Injury / etiology
  • Reperfusion Injury / prevention & control*
  • Swine
  • Time Factors
  • Tissue Survival / drug effects
  • Tissue and Organ Harvesting / adverse effects
  • Tissue and Organ Harvesting / methods*
  • Warm Ischemia

Substances

  • Biomarkers
  • Free Radical Scavengers
  • Insulin
  • Organ Preservation Solutions
  • University of Wisconsin-lactobionate solution
  • Allopurinol
  • Glutathione
  • Adenosine
  • Raffinose
  • Edaravone
  • Antipyrine