Physiologic study of bile salt and lipid secretion in rats after liver transplantation.

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OBJECTIVE: This experiment determined the effects of liver transplantation on bile salt kinetics and biliary lipid secretion. SUMMARY BACKGROUND DATA: Depression of bile secretion in the three main components and bile cholesterol supersaturation with a high incidence of cholesterol stone formation have been documented in patients with end stage liver diseases after transplantation. However, physiologic changes of bile salt and lipid secretion in recipients remain unclear. METHODS: The study was done using a rat liver transplant model with 1 and 6 hours of donor liver cold preservation in saline. A chronic common bile duct fistula and a duodenal cannula were established for bile collection and the sample biochemical study for 6 days. RESULTS: Altered bile salt kinetics in liver grafted rats included depressed bile flow for 1-3 hours after the revascularization, decreased bile salt concentration and outputs, reduced bile salt basal synthesis rate, and reduced bile salt pool size during the early postoperative period. Phospholipid concentration and secretion rate depressed for 1-3 days without altered cholesterol level. The uncoupling change of the cholesterol and the other bile components resulted in an increased lithogenic indices in bile on days 2 and 3. CONCLUSION: Alterations of bile composition and bile salt kinetics occur in liver transplanted rats. The changes may result from injuries of the liver microcirculation and parenchymal cells caused by cold preservation. The study of bile secretion is helpful for evaluation of the initial graft function. The changed ratio of three bile components may be important for cholesterol stone formation in the liver transplant recipient.

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