190 The physiological incongruity that may be associated with orthotopically transplanted livers across discordant but not concordant species is being widely debated. Of primary concern is the different methods employed by various species for bile secretion. While in both rats and hamsters (HAM) this phenomenon is bile acid-dependent; in guinea pigs (GP) on the contrary, it is driven largely by osmosis established by a HCO3- concentration gradient. Additionally, bile flow is also appreciably higher (×4) in GP as compared to that in rats. In the light of heretofore raised arguments, we proceeded to ascertain the effect of these anomalies on the HCO3- and pH of rat recipients of GP livers (Group VI). Recipients of liver transplantation (LTX) across syngeneic (syn; Group IV) and concordant (con; HAM→ rat; Group V) strain combinations were used as controls. Recipients in Group IV, V and VI received cobra venom factor (80µg/kg) on d-1 as well as tacrolimus (1mg/kg/d) and CellCept (10mg/kg/d) from d-1 onwards. Arterial blood samples were collected on d1 and 2 post-Tx for analysis, the results are as follows: While the use of immunosuppression completely prevented the rejection of xenografts in Group V animals, it failed to prolong survival in Group VI recipients beyond d3 post-Tx. However, for the first two post-operative days except for slight hyperventilation, animals in Group VI were active and with normal behavior. As is depicted in the table, blood pH, pCO2 and HCO3- levels remained stable in animals in Group IV and V. However within 24 hours post-Tx, the HCO3- levels in Group VI animals were significantly reduced with an accompanying decrease in pH. Additionally, respiratory compensation in these recipients also markedly reduced the pCO2 levels. While, HCO3- levels in the bile of naive rats and HAM were found to be similar (37.1±2.7 and 31.6±3.6 mmol/L, respectively), they were nevertheless, 3× higher (103.8±5.0 mmol/L) in the bile of GP. This phenotype was preserved in Group VI recipients where bile HCO3- levels increased 3-fold to around 100 mmol/L on dl and 2 post-Tx. In conclusion, the higher concentration of HCO3- in the bile of GP livers along with a higher flow rate results in rapid loss of HCO3- buffer from the plasma of GP→ rat liver transplant recipients who exhibit a propensity towards developing metabolic acidosis. Immunological discordancy should not be viewed as a separate entity, for it is coupled with physiological and metabolic incompatibilities observed especially after Tx of a multifunctional organ such as a liver across genetically disparate species.Table
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