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Gas exchange abnormalities in patients listed for liver transplantation

100%
Przybylowski T., Krenke R., Fangrat A., Nasilowski J., Grabczak E. M., Styczynski G., Pruszczyk P., Krawczyk M., Chazan R.
Journal of Physiology and Pharmacology. Supplement
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2006
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tom 57
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nr 4
313-323
Abnormalities of pulmonary gas exchange are common in patients with advanced liver disease. Since arterial blood hypoxemia is an important issue in the preoperative evaluation of liver transplant candidates, the study was undertaken to determine the incidence and severity of lung function impairment with a special emphasis on pulmonary gas exchange abnormalities in this group of patients. 104 consecutive patients (47 F and 57 M, mean age 46 ±11 yr) listed for orthotopic liver transplantation participated in this prospective study. All patients underwent evaluation including: clinical assessment (Child-Pough and MELD classification), chest X-ray, chest sonography, lung function tests, arterial blood gases measurement, and transthoracic contrast enhanced echocardiography. There were 2 patients with acute hepatic failure, 6 patients with primary or metastatic liver carcinoma, and 96 patients with chronic liver disease. The mean PaO2 and lung function parameters for the entire group were within normal limits. There were 29 hypoxemic patients (PaO2< 80 mmHg) and 40 patients with widened (>20 mmHg) P(A-a)O2. DLCO was significantly lower in cirrhotic vs. non-cirrhotic patients (76.5 ±19.3 vs. 92.4 ±19.0% predicted; P<0.001). Hepatopulmonary syndrome (HPS) was recognized in 23 (24%) patients. 91% of patients with HPS showed mild to moderate stage of disease. There were significant difference between differences HPS patients and non-HPS patients in DLCO (69.0 ±14.5 vs. 83.5 ±20.7, P<0.01). In conclusion, all patients referred for OLT should be screened for gas exchange abnormalities. Such a workup should include not only PAO2 but also DLCO and P(A-a)O2 measurement together with contrast enhanced echocardiography.
2

Arginase isoenzymes in human cirrhotic liver

80%
Chrzanowska A., Gajewska B., Baranczyk-Kuzma A.
Acta Biochimica Polonica
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2009
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tom 56
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nr 3
465-469
 Cirrhosis leads to an inability of the liver to perform its biochemical functions. It can also lead to hepatocellular carcinoma in which, as we showed lately, arginase isoenzyme pattern changes. The present work presents our results on arginase isoenzymes and their possible role in liver cirrhosis. The study was performed on tissues obtained during liver transplantation from 60 patients with liver cirrhosis, and on samples of histologically normal liver (control) from 40 patients with benign or colorectal cancer liver metastases removed during surgery, 6-7 cm from the tumor border. Arginase isoenzymes AI (so-called liver-type arginase) and AII (called extrahepatic arginase) were identified by Western blotting and isolated by ion-exchange chromatography. Their expression on mRNA level was studied by RT-PCR. A significant decrease in arginase activity, dependent of the liver clinical stage, was observed in cirrhotic tissue. Arginase AI activity and its mRNA level were significantly decreased in cirrhotic liver, whereas the activity and expression of arginase AII were concurrently raised, as compared to normal liver. Since arginase AI is a key enzyme of the urea cycle, whereas arginase AII most probably takes part in the biosynthesis of ornithine and polyamines, the defective ammonia inactivation and increased collagen biosynthesis observed in cirrhotic liver may be related to the changes in arginase AI and AII levels, respectively.
3
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Pathogenesis and clinical consequences of iron overload in chronic hepatitis C - impact of host and viral factors related to iron metabolism

80%
Sikorska K., Romanowski T., Bielawski K. P.
BioTechnologia. Journal of Biotechnology Computational Biology and Bionanotechnology
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2011
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tom 92
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nr 1
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