Livers are so delicate that even the most robust donor samples fail if they are not transplanted within 24 hours. But a fortuitous coincidence led to the discovery that interferon (IFN) , a powerful anticancer drug, may double the lifetime of donor livers. The discovery, published in the November issue of Gastroenterology , could greatly improve donor livers supply and relieve some of the pressure on the complicated transplant procedure.
fresh donor livers are immersed in a cold solution of electrolytes and sugars to preserve their hepatocytes. These cells pumped up to 5000 different proteins involved in any of the blood clotting to detoxification. But almost freezing temperature quickly bloats the sinusoidal cells of the liver, which cover the blood vessels. After transplantation, the hypertrophied cells detach hepatocytes and die, weakening blood vessels and starving the liver blood.
There are two years, researchers at Duke University Medical Center were investigating how to better preserve chilled livers. A member of the team at the time was also brushing up on research on breast cancer after a relative had been diagnosed with the disease. According to Duke liver transplant surgeon Pierre-Alain Clavien, team member noticed a "striking similarity" between the early stages of tumor development and injury to chilled livers. liver sinusoidal cells were swollen exactly like their counterparts, endothelial cells during angiogenesis, the growth of blood vessels in a tumor
The team tested as liver conservative three common cancer drugs - . fumagalin, minocycline and IFN - which inhibit angiogenesis. They injected the drug to rats before removing the livers of animals and organ extracts as well. IFN- was the only one to provide a "significant" improvement in the shelf life of sinusoidal cells, said Clavien. Because circulating IFN levels peaked in rats 2-6 hours after injection, he believes that a single dose given a few hours before an organ is removed from a rat - and the adding the drug to the preservation solution--Could do donor livers had perhaps 48 hours.
new research offers a "unique perspective" on the liver damage process, says Gregory Gores, transplant hepatologist at Mayo Clinic in Rochester, Minnesota. But the implication of the paper - the sinusoidal cells trying to develop blood vessels, rather than simply die - "is a hypothesis that has to be proven." This evidence, Gores says, is to identify the protein that triggers angiogenesis and looking for it in the liver.
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