Ultrastructural Changes in the Contralateral Lung Tissue Following Unilateral Lung Ischemia: An Experimental Study in Rabbits

PubMedID: 14714228Purpose. To investigate the acute ultrastructural changes that may occur in the contralateral nonischemic lung tissue after unilateral ischemia of a lung in a rabbit model. Methods. The animals were divided into three main groups of eight; namely, a 2-h procedure group, a 4-h procedure group, and an 8-h procedure group. Each of these groups was further divided into two subgroups of four rabbits each; namely, a control group, given a sham operation without any ischemic insult, and an ischemia group, in which the main pulmonary arteries, the pulmonary veins, and the main bronchi of the left lungs were ligated after thoracotomy. Tissue samples were taken from the left and right lungs to examine the ultrastructural changes after 2, 4, and 8 h of ischemia. Each sample was given a semiquantitative histological injury score. Statistical analysis was done by the Mann-Whitney U-test. Results. Contralateral ultrastructural damage, evident by heterochromatin in the nuclei, mitochondrial degeneration, cisternal widening of the endoplasmic reticulum, increased lipid droplets, and lysosomes, was determined by electron microscopy after unilateral lung ischemia. The contralateral lung injury was significantly correlated with the duration of ischemia. Conclusions. Unilateral lung ischemia affected the bilateral lungs in a rabbit model. Therefore, in operations such as single-lung transplantation, pulmonectomy, or lobectomy, if the procedure is unnecessarily prolonged, the contralateral lung may be damaged, which could seriously affect the prognosis of the patient

Examining the Hepatic Immune System in Children With Liver Disease With Fine Needle Aspiration

Objectives: Liver biopsy is the standard in diagnosing liver diseases. Yet, it provides little space to perform comprehensive immune profiling of the liver. Hence, we explored whether fine needle aspirates (FNAs) could be used to elucidate the hepatic immunity in children. Methods: We enrolled 74 children undergoing diagnostic (n = 17) or protocol biopsy (n = 57) following liver transplantation (LT). Matched blood and FNAs were obtained. Additionally, explant liver tissue was collected from children (n = 14) undergoing LT. Immune cells were isolated from peripheral blood, FNAs and explanted livers. Immune-phenotypical profiling was done by flow cytometry. Results: Biopsied patients (58% female) were at a median age of 46 months (interquartile range [IQR]: 12–118) and LT patients (71% female) were 48 months (IQR: 21–134, P = 0.78) old. CD69+, a hallmark of tissue-resident immune cells was expressed in 1.3% of CD3+ T cells from blood being higher in FNA (20%) and tissue (49%, P < 0.001). CD4+ T-cell frequencies in tissue (13%) and FNAs (20%) were lower compared to blood (35%, P < 0.001) whereas CD8+ T cells in tissue (33.5%) and FNA (32%) were higher than in blood (25%, P < 0.01). Mucosal associated invariant T cells were enriched in liver tissue (8.8%) and in the FNA (4.4%) compared to blood (1.7%, P < 0.001). Whereas the percentage of total Tregs (CD4+CD25+FOXP3+CD127low/−) decreased, the proportion of activated Tregs (CD4+CD45RA-FOXP3high) increased in FNA and explant. Breg (CD19+CD20+CD24highCD38high) frequencies were similar in all groups. Conclusion: FNA is a practical method to sample the liver immune system collecting even small cell subsets such as regulatory T/B cells

Donor bile duct evaluation with magnetic resonance cholangiography in living-donor liver transplantation: a novel anatomical classification for predicting surgical techniques

PURPOSETo propose a novel, inclusive classification that facilitates the selection of the appropriate donor and surgical technique in living-donor liver transplantation (LDLT).METHODSThe magnetic resonance cholangiography examinations of 201 healthy liver donors were retrospectively evaluated. The study group was classified according to the proposed classification. The findings were compared with the surgical technique used in 93 patients who underwent transplantation. The Couinaud, Huang, Karakas, Choi, and Ohkubo classifications were also applied to all cases.RESULTSThere were 118 right-lobe donors (58.7%) and 83 left-lateral-segment donors (41.3%). Fifty-six (28.8%) of the cases were classified as type 1, 136 (67.7%) as type 2, and 7 (3.5%) as type 3 in the proposed classification; all cases could be classified. The number of individuals able to become liver donors was 93. A total of 36 cases were type 1, 56 were type 2, and 1 was type 3. Of the type 1 donors, 83% required single anastomosis during transplantation, whereas six patients classified as type 1 required two anastomoses, all of which were caused by technical challenges during resection. Moreover, 51.8% of the cases classified as type 2 required additional anastomosis during transplantation. The type 3 patient required three anastomoses. The type 1 and type 2 donors required a different number of anastomoses (P < 0.001).CONCLUSIONThe proposed classification in this study includes all anatomical variations. This inclusive classification accurately predicts the surgical technique for LDLT

Caustic esophageal injury decreases the number of interstitial cells of Cajal in the rat esophagus

Soyer, Tutku/0000-0003-1505-6042WOS: 000281832100013Aim: To evaluate the effect of caustic esophageal injury (CEI) on the number of interstitial cells of Cajal (ICC) Materials and methods: Wistar rats were divided into 3 groups. control, acid, and alkali induced CEI CEI was performed by the injection of 1 mL of 10% hypochloric acid in the acid group, and 1 mL of 10% sodium hydroxide was injected into the alkali group. Distal esophageal segments were removed 24 h after injection CEI was graded and the number of ICC were investigated (CD-117 staining) The number of ICC was compared in groups and correlated with CEI grades Results: Typical histopathologic features of CEI were encountered in acid (mean grade 0 25 +/- 0.15), and in alkali (median 2, range. 1 25-3) groups The number of ICC was decreased in both the acid (mean 12 8 +/- 9.2) and alkali (median 2, range 0.0-4 0) groups with respect to the control group (mean 30 5 +/- 6 5) (P < 0 05) In addition, alkali group had a decreased number of ICC, when compared to the acid group (P < 0 05) Histopathologic grading showed an inverse correlation with number of ICC in both the acid (rs: 0 678) and alkali (rs 0.759) groups Conclusion: CEI decreases the number of ICC in the rat esophagus. Alkali caustics cause a higher grade of esophageal injury and a greater decrease in the number of ICC Motility disorders after caustic ingestion may be related to the decreased number of IC

Post-donation evaluation of life of donors of liver transplantation

Aim: Liver transplantation from living donors affects not only recipients’ but also donors’ lives. The aim of this study was to explore living donors’ experience of life. Methods: The sample consisted of 16 living donors who donated a part of their liver to a patient who had end-stage liver failure. Anonymised interview transcripts were analyzed following established conventions. Results: The analysis showed that participants evaluated their life in terms of limitations brought by organ donation surgery, awareness of the need for lifestyle changes, emotional changes, changes in character, and mixed relationships. Emotional changes involved the experience of both negative and positive emotions (feeling reputable, feeling like being born again). Changes in character included both worsening of character (becoming half human, turning into an aggressive person) and positive changes in character (becoming more of a believer and a humanist). Mixed relationships included feeling supported by loved ones and doctors, reduction of burden of care, formation of a special bond, not feeling supported by potential supporters like mothers, or spouses and worsening of close relationships. Conclusions: Some findings (experience of negative emotions, lack of support from others) could be interpreted in terms of existing psychological theory. Other findings (worsening aspects of character, experience of positive emotions, improvement in aspects of character, formation of a special bond, worsening of close relationships) extended the literature and could be viewed as targets for educational programs for donors

Pediatric Liver Transplant: A Single-center Study of 100 Consecutive Patients

Objectives: Here, we present the outcomes of 100 consecutive pediatric liver transplant patients in our center