The Role of Calcium and Calcium Channel Blocking Drugs in Damage to The Liver Preserved for Transplantation
M Trocha, A Szelag
Ann Transplant 2004; 9(3): 5-12
Available online: 2004-10-29
Calcium plays a crucial role in physiological process in liver cells however in high concentrations these ions can be pathogenic and lead to cell death. Mechanisms responsible for maintaining calcium ion concentration gradient in physiological conditions include transmembrane transport, storage in intracellular organelles and binding to cytoplasmatic proteins. Ischemia, sepsis, anoxia and action of toxins are responsible for uncontrolled influx of calcium and consequently cell damage. Liver damage during its preservation for transplantation is connected with dysfunction of many enzymes, damage of cell membrane and cytoskeleton proteins. During reperfusion Kupffer cells are activated, reactive oxygen species are produced and microcirculation is disordered by calcium – dependent processes. Calcium channel blocking (CCB) drugs exhibit immunomodulatory impact and positive interaction with cyclosporine or tacrolismus. They also have cytoprotective properties during preservation end reperfusion time. They seem to improve liver function, decrease liver cell damage, elevate bile production, decrease lipid peroxydation and free radicals production. But in some experiments CCB do not modify calcium concentration. More research on preservation conditions is needed to increase the probability of a successful liver transplantation.
Keywords: Liver, Preservation, Calcium IonsReperfusion, Calcium Ions, Calcium Channel Blocking Drugs