Post-perfused Liver Research Articles

Hippo (YAP)-autophagy axis protects against hepatic ischemia-reperfusion injury through JNK signaling.

Hepatic ischemia-reperfusion injury (HIRI) remains a common complication during liver transplantation (LT) in patients. As a key downstream effector of the Hippo pathway, Yes-associated protein (YAP) has been reported to be involved in various physiological and pathological processes. However, it remains elusive whether and how YAP may control autophagy activation during ischemia-reperfusion. Human liver tissues from patients who had undergone LT were obtained to evaluate the correlation between YAP and autophagy activation. Both an in vitro hepatocyte cell line and in vivo liver-specific YAP knockdown mice were used to establish the hepatic ischemia-reperfusion models to determine the role of YAP in the activation of autophagy and the mechanism of regulation. Autophagy was activated in the post-perfusion liver grafts during LT in patients, and the expression of YAP positively correlated with the autophagic level of hepatocytes. Liver-specific knockdown of YAP inhibited hepatocytes autophagy upon hypoxia-reoxygenation and HIRI ( P <0.05). YAP deficiency aggravated HIRI by promoting the apoptosis of hepatocytes both in the in vitro and in vivo models ( P <0.05). Attenuated HIRI by overexpression of YAP was diminished after the inhibition of autophagy with 3-methyladenine. In addition, inhibiting autophagy activation by YAP knockdown exacerbated mitochondrial damage through increasing reactive oxygen species ( P <0.05). Moreover, the regulation of autophagy by YAP during HIRI was mediated by AP1 (c-Jun) N-terminal kinase (JNK) signaling through binding to the transcriptional enhanced associate domain (TEAD). YAP protects against HIRI by inducing autophagy via JNK signaling that suppresses the apoptosis of hepatocytes. Targeting Hippo (YAP)-JNK-autophagy axis may provide a novel strategy for the prevention and treatment of HIRI.

Prognostic value of the morphological features of postperfusion liver biopsies in liver transplantation

Purpose: The aim of this study was to show the potential prognostic effects of morphological findings for the graft function, rejection and survival by evaluating the postperfusion liver biopsies.&#x0D; Materials and Methods: Sixty six cases who underwent cadaveric liver transplantation between 2006-2010 were included. The representative slides of postperfusion subcapsular wedge biopsies were evaluated for intrasinusoidal neutrophilic infiltration, microvesicular steatosis, hepatocyte swelling, hepatocellular necrosis, endothelial swelling, bile duct epithelial changes, cholangiolar proliferation and sinusoidal congestion/hemorrhage. The associations between the histopathological features and early allograft dysfunction, mortality rate and rejection status were statistically analysed.&#x0D; Results: Intrasinusoidal neutrophilic infiltration was grade 1 in 40 (60%), grade 2 in 24 (36%), and grade 3 in 2 cases (4%). The presence of grade 2-3 intrasinusoidal neutrophils was found to be significantly associated with mortality rate. The presence of sinusiodal congestion/hemorrhage was statistically related to the rejection. The presence of sinusiodal congestion/hemorrhage was significantly associated with shorter overall survival.&#x0D; Conclusion: Intrasinusoidal neutrophilic infiltration is promising to be a possible histopathological predictor for mortality. In addition, the presence of sinusoidal congestion can be a candidate as a prognostic factor both for rejection and overall survival based on our study.

A Small Animal Model of Ex Vivo Normothermic Liver Perfusion.

There is a significant shortage of liver allografts available for transplantation, and in response the donor criteria have been expanded. As a result, normothermic ex vivo liver perfusion (NEVLP) has been introduced as a method to evaluate and modify organ function. NEVLP has many advantages in comparison to hypothermic and subnormothermic perfusion including reduced preservation injury, restoration of normal organ function under physiologic conditions, assessment of organ performance, and as a platform for organ repair, remodeling, and modification. Both murine and porcine NEVLP models have been described. We demonstrate a rat model of NEVLP and use this model to show one of its important applications - the use of a therapeutic molecule added to liver perfusate. Catalase is an endogenous reactive oxygen species (ROS) scavenger and has been demonstrated to decrease ischemia-reperfusion in the eye, brain, and lung. Pegylation has been shown to target catalase to the endothelium. Here, we added pegylated-catalase (PEG-CAT) to the base perfusate and demonstrated its ability to mitigate liver preservation injury. An advantage of our rodent NEVLP model is that it is inexpensive in comparison to larger animal models. A limitation of this study is that it does not currently include post-perfusion liver transplantation. Therefore, prediction of the function of the organ post-transplantation cannot be made with certainty. However, the rat liver transplant model is well established and certainly could be used in conjunction with this model. In conclusion, we have demonstrated an inexpensive, simple, easily replicable NEVLP model using rats. Applications of this model can include testing novel perfusates and perfusate additives, testing software designed for organ evaluation, and experiments designed to repair organs.

Effects of Dietary Soybean Peptides on Hepatic Production of Ketone Bodies and Secretion of Triglyceride by Perfused Rat Liver

Soybean protein isolate (SPI) was digested with protease to produce a peptides containing the low-molecular fraction (LD3) or a mixture of high- and low-molecular fractions (HD1). Rats were fed a diets containing SPI, LD3, or HD1 at a protein level equivalent to the 20% casein diet for 4 weeks. The serum triglyceride concentration was lower in rats fed SPI, LD3, and HD1 diets than in rats fed the casein diet, and the differences were significant for the cholesterol-enriched diet. The value for the LD3 group was the lowest among all groups for both the cholesterol-free and -enriched diets. The level of triglyceride in the post-perfused liver was significantly lower in the LD3 and HD1 groups and the SPI group than in the casein group irrespective of the presence of cholesterol in the diet. In the cholesterol-free diet, LD3 feeding as compared to casein feeding caused a reduction in triglyceride secretion from the liver to perfusate and an increment of hepatic ketone body production. The addition of cholesterol to the diets somewhat attenuated these effects of LD3. These results suggest that the low-molecular fraction in soybean peptides causes triglyceride-lowering activity through a reduction in triglyceride secretion from the liver to the blood circulation and the stimulation of fatty acid oxidation in the liver. There is a possibility that soybean peptides modulate triglyceride metabolism by changes in the hepatic contribution.

E2 quasispecies specificity of hepatitis C virus association with allografts immediately after liver transplantation

It is unknown whether all hepatitis C virus (HCV) quasispecies variants found within patient serum have equal capacity to associate with the liver after transplantation; however, in vitro models of HCV infection suggest that variations in the hypervariable region 1 (HVR1) of the second envelope protein (E2) may be important in infectivity. The hypothesis of the current study is that the two hypervariable regions (HVR1 and HVR2) within E2 are important in the initial virus-liver interaction, and, therefore, certain HCV quasispecies variants will be isolated from the liver after reperfusion. In 8 patients with end-stage liver disease secondary to HCV infection, HCV envelope quasispecies were determined from intraoperative serum samples obtained before the anhepatic phase of transplantation and from liver biopsies 1.5 to 2.5 hours after the transplanted liver was perfused. Explanted (native) liver biopsies were taken as a control. Sequence analysis was performed on clones of specific HCV reverse transcriptase-polymerase chain reaction products spanning HVR1 and HVR2 of the E2 protein. HVR1 was more variable than HVR2 for all samples. Quasispecies isolated from postperfusion liver differed more from serum than did explanted liver quasispecies at HVR1 (P = 0.03) but not at HVR2 (P = 0.2). Comparison of HVR1 sequences from postperfusion liver versus serum revealed significantly less HVR1 genetic complexity and diversity (P = 0.02 and P = 0.04, respectively). Immediately after transplantation but before actual infection, liver allografts select out from the infecting serum inoculum a less heterogeneous, more closely related population of quasispecies variants.

Dietary conjugated linoleic acid reciprocally modifies ketogenesis and lipid secretion by the rat liver.

The effects of dietary conjugated linoleic acid (CLA) and linoleic acid (LA) on ketone body production and lipid secretion were compared in isolated perfused rat liver. After feeding the 1% CLA diet for 2 wk, the concentration of post-perfused liver cholesterol was significantly reduced by CLA feeding, whereas that of triacylglycerol remained unchanged. Livers from CLA-fed rats produced significantly more ketone bodies; and the ratio of beta-hydroxybutyrate to acetoacetate, an index of mitochondrial redox potential, tended to be consistently higher in the liver perfusate. Conversely, cumulative secretions of triacylglycerol and cholesterol were consistently lower in the livers of rats fed CLA, and the reduction in the latter was statistically significant. Thus dietary CLA appeared to exert its hypolipidemic effect at least in part through an enhanced beta-oxidation of fatty acids at the expense of esterification of fatty acid in the liver.

Increased secretion of triglyceride and cholesterol following inhibition of long-chain fatty acid oxidation in rat liver.

The effects of emeriamine, a fungal metabolite and a potent inhibitor of mitochondrial fatty acid oxidation, on ketogenesis and lipid secretion were examined in isolated perfused livers from 2-day-fasted rats. Liver perfusion with increasing concentrations of emeriamine up to 3 mumol caused a dose-dependent inhibition of ketone body production. The hepatic uptake of exogenous oleic acid substrate was comparable in the control and emeriamine-treated livers. The addition of 2 mumol emeriamine to the perfusion medium at either the beginning of perfusion or 2 h later caused immediate and almost complete cessation of ketone body production, which was accompanied by a concomitant decrease in the beta-hydroxybutyrate: acetoacetate ratio, suggesting a decreased production of NADH via mitochondrial beta-oxidation. Conversely, both triglyceride and cholesterol secretions were elevated, indicating a reciprocal response in ketogenesis and lipid secretion by the livers. The proportion of oleate in the perfusate triglyceride obtained from emeriamine-treated livers was significantly higher than that from control livers. In the post-perfused liver triglyceride, oleate was progressively increased in the livers treated with the inhibitor 2 h after perfusion and at the beginning of perfusion, respectively. These results indicate that direct inhibition of fatty acid oxidation diverts the exogenous fatty acids to the esterification pathway, and subsequently stimulate the synthesis and secretion of triglyceride and cholesterol. The fatty acid oxidation rate in the liver is, therefore, a critical determinant for the synthesis and secretion of these lipid components.

Modified simple cold storage of rat livers with UW solution.

Rat livers were preserved with the conventional use of UW solution for 30, 42, and 48 hr and compared with livers in which the vascular bed was expanded with an additional 10 to 60 ml UW/100 g liver. The extra UW, expressed as % liver weight, was entrapped during final portal infusion by typing off the supra- and infrahepatic inferior vena cava. A beneficial influence of the vascular expansion was most pronounced in the 40% group, with 10/10, 5/10, and 3/10 long-term survivors following transplantation after 30, 42, and 48 hr preservation versus 3/10 and 0/10 after 30 and 42 hr in the 0% controls. In separate experiments, surrogate indices of preservation quality following reperfusion explained this effect. The 40%--and, to a lesser extent, 20%--livers had higher and more uniformly distributed portal blood flow, better tissue oxygenation, smaller increases in postperfusion liver enzymes, higher adenine nucleotides and energy charge, and less histopathologic evidence of hemorrhage and congestion. Pressure changes in the vena cava fluid sump in additional experiments indicated that retrograde infusion of the trapped UW solution occurred in all of the 10-60% groups during the first 6 hr with stable pressures of 1.5 to 3 cm H2O thereafter. Collectively, these data suggest that the much discussed selective vulnerability of the microvasculature of stored allografts is due in part (or principally) to its selective lack of long-term exposure to the UW solution, which drains out of the open vessels but not from the parenchyma. The potential clinical exploitation of this concept is discussed.

A comparison of the metabolism of cis,cis-, cis,trans/trans,cis- and trans,trans-9,12-octadecadienoic acids in rat liver

The effect of geometrical isomers of 9,12-octadecadienoic (18:2) acid on ketogenesis and lipid secretion was compared in isolated perfused rat liver. The hepatic uptake of 18:2 acid isomers was similar in the cis,cis (cc)-, trans,trans (tt)-and a mixture of cis,trans/trans,cis (ct/tc)-isomers. The trans-isomers in comparison with the cis-counterpart stimulated ketogenesis, while reduced hepatic secretion of triacylglycerol and cholesterol and the concentration of triacylglycerol in the post-perfused liver. This reciprocal response was dependent on the number of trans double bonds. The trans-isomers infused during the 4h-perfusion periods were actively incorporated into hepatic lipids and secreted at the expense of endogenous cc-18:2 acid, although the mixture of the mono- trans isomers as compared to the di- trans isomer incorporated more into liver lipids except for phospholipid. On the other hand, less ct-18:2 was incorporated than tc-18:2 into both hepatic and perfusate lipids. These results indicate that both the position and the number of the trans-double bonds in the 18:2 acid determine the pathways of oxidation and esterification.

Effects of oleic, arachidonic and 5,8,11,14‐nonadecatetraenoic acids on lipid secretion and ketogenesis in perfused rat liver

The effects of perfused oleic (18:1n-9), arachidonic (20:4n-6) and 5,8,11,14-nonadecatetraenoic (19:4n-5) acids on triglyceride and cholesterol secretion and ketone body production were studied in isolated rat liver. As compared to oleic and 19:4n-5 acids, both ketone body production and triglyceride secretion were significantly lowered when arachidonic acid was perfused. The concentration of triglyceride in the post-perfused liver was lower upon perfusion with arachidonic acid than upon perfusion with oleic acid or 19:4n-5 acid. Cholesterol secretion in the liver perfused with arachidonic acid or 19:4n-5 acid was significantly higher than with oleic acid. The concentration of cholesterol in the post-perfused liver was slightly but significantly higher with 19:4n-5 acid than with the other fatty acids. The results suggest that 19:4n-5 acid when compared with arachidonic acid affects lipid metabolism in liver differently.

Altered hepatic metabolism of free fatty acid in rats fed a threonine-imbalanced diet.

The effects of a threonine-imbalanced diet (8% casein supplemented with 0.3% methionine, TI) on the ketone body production and the secretion rate of lipids were examined in the isolated perfused rat liver. Feeding a TI diet compared to an 8% casein (C) diet resulted in an enlargement of liver, presumably due to 2-4-fold accumulation of triglyceride. Serum triglyceride likewise increased significantly in rats fed a TI diet. No significant difference was found in the other lipid components both in serum and liver. When the livers from rats fed C or TI diets were isolated and perfused in the presence of an exogenous oleate substrate, the TI diet decreased the ketone body production and conversely increased the secretion rate of triglyceride, suggesting an inverse relationship between rates of ketogenesis and triglyceride secretion. The proportion of oleate in the perfusate triglyceride obtained at the end of perfusion was comparable between the C and TI groups, whereas in the post-perfused liver it was higher in the former than in the latter, suggesting a stimulatory effect of the TI diet on the secretion of the oleate in the form of triglyceride. These results indicate that altered hepatic metabolism of long-chain free fatty acids between the pathways of oxidation and esterification is one of the causative factors for triglyceride accumulation in the liver produced by threonine imbalance.

In vitro hepatic insulin resistance in chronic pancreatitis in the rat

To investigate the effect of chronic pancreatitis (CP) on in vitro hepatic sensitivity to insulin, the suppression of glucagon-stimulated hepatic glucose production (HGP) by insulin was examined during isolated liver perfusion (ILP) in CP and sham-operated rats. CP was induced at laparotomy by infusion of 50 μl 99% oleic acid into the common bile duct during temporary occlusion of the proximal hepatic duct in 250- to 350-g Sprague-Dawley rats. Eight to sixteen weeks later, single-pass ILP was performed on fed animals. Glucagon (100 pg/ml) was infused for 30 min; the final 20 min of perfusion was performed with (a) no insulin, (b) 25 μ/ml insulin, or (c) 100 μU/ml insulin. CP and sham rats demonstrated comparable HGP responses to glucagon during the 0- to 10-min period (5.2 ± 0.5 vs 5.9 ± 0.5 mg/g/min, P = NS). CP rats demonstrated an HGP response to glucagon alone more evanescent than that in sham rats (20–30 min of HGP, 6.6 ± 0.6 vs 9.5 ± 0.4 mg/g/min, P < 0.05). Sham rats showed a dose-dependent inhibition of HGP by insulin, however (percentage 20–30 min of HGP/0–10 min of HGP for 0, 25, and 100 μU/ml insulin: 166 ± 12, 125 ± 7, and 101 ± 5%, P < 0.01), whereas CP rats showed no effect of insulin (130 ± 6, 123 ± 7, 134 ± 7%, P = NS). Pre- and postperfusion liver glycogen contents revealed comparable decreases in liver glycogen in both groups: insulin inhibition of HGP in sham rats was accompanied by higher postperfusion glycogen content. These data demonstrate a loss of insulin-mediated suppression of hepatic glucose production in livers obtained from pancreatitic rats. We conclude that CP is accompanied by a primary hepatic resistance to insulin; this defect may play a role in the etiology of pancreatogenic diabetes.

Effect of clofibrate on the metabolism of oleate in the perfused rat liver

The effect of clofibrate on the metabolism of [1-14C]- and [U-14C]oleate was examined in the perfused rat liver. Clofibrate feeding severely reduced hepatic triglyceride secretion and enhanced ketone body production. The increase in the rate of incorporation of labeled tracers into perfusate oxidation products and ketone bodies due to the clofibrate treatment was demonstrated only with [U-14C]oleate. Clofibrate strongly reduced the rate of incorporation of oleate into perfusate triglyceride, whereas that into the phospholipid fraction of the post-perfused liver doubled. In consequence, the sum of the radioactivities in esterified lipids in the perfusate and the post-perfused liver was not altered by clofibrate. A clofibrate-dependent increase in phospholipid synthesis may restrict the amount of exogenous fatty acid which is available for the formation of triglyceride-rich lipoproteins.