ADENINE NUCLEOTIDE METABOLISM DURING HEPATIC ISCHEMIA AND SUBSEQUENT BLOOD REFLOW PERIODS AND ITS RELATION TO ORGAN VIABILITY

Abstract

In an experimental model system for liver transplantation, the ability of the rat liver to synthesize ATP and to maintain adequate energy charge and total adenine nucleotides during restoration of hepatic blood flow following warm ischemia was found to determine tissue vaibility and survival of the animal. A portafemoral shunt prepared to relieve portal congestion enhanced the rate and extent of ATP resynthesis by the reflow following hepatic ischemia and this was accompanied by an increase in the survival rate of the rat. It is important to ascertain the functional and structural damages of the liver under ischemic conditions and subsequently to predict viability of the organ in its transplantation. Because of the high metabolic rate, hepatic cells are sensitive to the deleterious influence of anoxia. There is still considerable uncertainty as to the specific sequence of biochemical events leading to the irreversible injury and subsequent death of ischemic cells. The recovery rate of the reduced ATP level during reflow after warm ischemia in the kidney or brain could apparently be used to determine tissue viability and survival rate of the rat. The ability of the liver to maintain its energy metabolism adequately through the regeneration of ATP during reflow is apparently closely related to tissue viability and the survival rate of the animal.