BACKGROUND:?Inevitable? warm? ischemia? time? before?organ?procurement?aggravates?posttransplantation?ischemia-reperfusion? injury.? Endoplasmic? reticulum? (ER)? stress? is?involved?in?ischemia-reperfusion?injury,?but?its?role?in?donation?after?cardiac?death?(DCD)?liver?transplantation?is?not?clear?and?the?effect?of?ER?stress?inhibitors,?tauroursodeoxycholic?acid?(TUDCA)?and?4-phenyl?butyric?acid?(PBA),?on?the?prognosis?of?recipient?of?DCD?liver?transplantation?remains?unclear.
METHODS:?Male? Sprague-Dawley? rats? (8-10? weeks)? were?randomly?divided?into?control?group:?liver?grafts?without?warm?ischemia?were?implanted;?DCD?group:?warm?ischemia?time?of?the?liver?grafts?was?60?minutes;?TUDCA?and?PBA?groups:?based?on?the?DCD?group,?donors?were?intraperitoneally?injected?with?TUDCA?or?PBA?30?minutes?before?the?organ?procurements.?Serum? aminotransferase? levels,? oxidative? stress? activation?and?expression?of?ER?stress?signal?molecules?were?evaluated.?Pathological?examinations?were?performed.?The?survivals?of?the?recipients?in?each?group?were?compared?for?14?days.
RESULTS:?Compared?with?the?control?group,?DCD?rats?had?signiifcantly?higher?levels?of?serum?aminotransferase?at?6?hours,?1?day?and?3?days?after?operation?(P<0.01,?0.01?and?0.05,?respectively)?and?oxidative?indices?(P<0.01?for?both?malondialdehyde?and?8-hydroxy?deoxyguanosine),?more?severe?liver?damage?(P<0.01)?and? up-regulated? ER? stress? signal? expressions? (P<0.01? for?GRP78,?phos-eIF2α1,?CHOP,?ATF-4,?ATF-6,?PERK,?XBP-1?and?pro-caspase-12).?All?recipients?died?within?3?days?after?liver?transplantation.?Administration?of?TUDCA?or?PBA?signiifcantly?decreased?aminotransferase?levels?(P<0.05),?increased?superoxide?dismutase?activities?(P<0.01),?alleviated?liver?damage?(P<0.01),?down-regulated? ER? stress? signal? expressions? (P<0.01)? and?improved?postoperative?survivals?(P<0.01).
CONCLUSIONS:?ER?stress?was?involved?with?DCD?liver?trans-plantation?in?rats.?Preoperative?intraperitoneally?injection?of?TUDCA?or?PBA?protected?ER?stress?and?improved?prognosis.