Calcium metabolism in porcine liver transplantation

: The influence of warm ischemia on calcium metabolism in liver transplantation (LTX) was investigated using temporary portal vein arterialization (PA) technique. Group I pigs were added no warm ischemia (n = 6). In group II, donors were killed by KCl, and the livers were left in situ for 60 min (n = 6). After anastomosing the suprahepatic vena cava, revascularization was carried out employing PA. Initial reperfused blood was collected through the infrahepatic vena cava. All pigs survived more than 4 days in group I, whereas all died within 2 days in group II. In group II, Ca2+ levels of initial reperfused blood were significantly lower than those of arterial blood. Ca2+ levels of initial reperfused blood in group II were significantly lower than those in group I. Within 90 min after revascularization, biliary output and biliary calcium content and excretion in group I recovered to 30%, 100% and 40% of normal, respectively, but in group II only 2 animals could excrete bile. In conclusion, in the liver with 60 min warm ischemia, Ca2+ influx occurred immediately after revascularization followed by decreased calcium excretion in bile, which suggested that accumulation of calcium might be one of the causes of warm ischemic injury.