Monitoring extracellular concentrations of lactate, glutamate, and glycerol by in vivo microdialysis in the brain during liver transplantation in acute liver failure

Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
Flemming Tofteng, Fin Stolze Larsen

Abstract

Swelling of cerebral glial cells is a characteristic complication in patients with acute liver failure (ALF). This astrocyte edema may result in high intracranial pressure (ICP) and brain herniation before or during liver transplantation. Metabolic alterations responsible for the development of high ICP in patients with ALF are not fully understood. We describe changes in neurochemistry during liver transplantation using a cerebral microdialysis technique in a young man with severe ALF and cerebral edema. We found that the extracellular content of lactate ([lactate](ec)) gradually increased during the operation. Because cerebral oxygen saturation and [lactate](ec) to [pyruvate](ec) ratio were within normal limits, hypoxia was not likely to be responsible for the increased [lactate](ec) levels. Instead, we found that [lactate](ec) levels correlated in this patient with arterial lactate concentrations during and after grafting (r(2) = 0.96; P <.05), but did not correlate with arterial glucose concentrations (r(2) = 0.20; P = not significant). Also, [glutamate](ec) and [glycerol](ec) levels were severely elevated before liver transplantation, but tended to decrease in the hours after grafting. These findings indicate disturbances ...Continue Reading

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Citations

Nov 9, 2002·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Fin Stolze Larsen, Julia Wendon
Jan 15, 2013·Gastroenterology Research and Practice·Irena Ciećko-MichalskaTomasz Mach
Jan 11, 2014·World Journal of Gastroenterology : WJG·Teresa R ScottDebbie L Shawcross
Nov 26, 2002·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Flemming ToftengFin Stolze Larsen
Aug 6, 2004·Current Opinion in Clinical Nutrition and Metabolic Care·Alberto Battezzati, Simona Bertoli
Oct 13, 2011·Neurochemistry International·Kakulavarapu V Rama Rao, Michael D Norenberg
Jul 6, 2010·Neurochemistry International·Christopher F Rose
Jan 9, 2013·Liver International : Official Journal of the International Association for the Study of the Liver·Laia ChavarriaJuan Cordoba
Apr 29, 2015·Journal of Hepatology·William BernalRoger Williams
Dec 20, 2003·Neurosurgery·Edward A Neuwelt
Aug 21, 2007·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Christopher RoseRajiv Jalan
Jan 24, 2003·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Claudia ZwingmannRoger F Butterworth
Feb 14, 2019·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Yohan BoillatRolf Gruetter
Aug 3, 2010·Liver International : Official Journal of the International Association for the Study of the Liver·Gavin WrightRajiv Jalan
Oct 27, 2012·Metabolic Brain Disease·P N Bjerring, F S Larsen
Aug 31, 2016·World Journal of Hepatology·Fernando Mendes PaschoalEdson Bor-Seng-Shu

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