Carbon monoxide hemoglobin and bilirubin metabolism in adult living-related liver transplantation
Hirano, K.; Sato, Y.; Kobayashi, T.; Yamamoto, S.; Nakatsuka, H.; Oya, H.; Kato, T.; Watanabe, T.; Kameyama, H.; Hatakeyama, K.
Hepato-Gastroenterology 50(54): 1745-1748
2003
ISSN/ISBN: 0172-6390 PMID: 14696395 Document Number: 558995
Background/Aims: Hemeoxygenase-1 produces carbon monoxide as a byproduct of hemoglobin metabolism. The present study examines the relationship between carbon monoxide production and hyperbilirubinemia following adult living-related liver transplantation with special attention to the contribution of shear stress in retarding regeneration. Methodology: Case records from 16 patients who underwent adult living-related liver transplantation from March 1999 to May 2001 were reviewed. Patients were divided into group A (graft weight: recipient body weight ratio gtoreq1) and group B (graft weight: recipient body weight ratio <1). Clinical characteristics and outcome in the two groups were compared. Results: Total serum bilirubin concentration and the direct : total serum bilirubin concentration were higher in group B than group A (p<0.01). Further, the carbon monoxide-hemoglobin concentration correlated with the total serum bilirubin concentration (r=0.81, p<0.0001) and also was higher in group B than group A (p<0.05). The arterial : ketone body ratio rose similarly during the first week in both groups. Conclusions: Persistent hyperbilirubinemia in small-for-size grafts and concomitant carbon monoxide-hemoglobinemia reflect both parenchymal and Kupffer cell dysfunction. The role of shear stress in the portal system and its relationship to portal hypertension are discussed.