Info

Halki Diabetes Remedy

Diabetes Holistic Treatment

Get Instant Access

a Added prior to use.

a Added prior to use.

can be reflushed via the portal vein or hepatic artery with a cold or warm electrolyte solution (e.g., Ringer's-lactate) or with albumin before clamp release.245

Carolina rinse solution (CR), developed by Lemasters and colleagues at the University of North Carolina, maintained the basic electrolyte composition of Ringer's lactate, but had added components and provided better results than a simple electrolyte rinse (see Table 9.S).246247 CR combines extracellular electrolyte composition with a mildly acidic pH, oncotic support (albumin or HES), antioxidants (allopurinol, glutathione, desferrioxamine), energy substrates (adenosine, glucose and insulin, fructose), vasodilators (calcium channel blockers), and glycine. As with UW, it was not clear which of the several components were effective and whether the effects were the result of the beneficial effects of the CR or the potentially harmful effects of a Ringer's-lactate rinse.248

Analysis of the various components and techniques indicates that the temperature of the rinse solution is preferably above the required cold-storage temperatures of 0°-4°C; rinses at ambient temperatures (20°C) and at body temperatures (37°C) have given better results. The preferred pH of the rinse may be slightly acidic (pH 6.8). Components that seem unnecessary are colloid (HES or albumin), nicardipine and magnesium, glucose, fructose, and insulin. Beneficial agents include adenosine, allopurinol, desferrioxamine, glutathione, and glycine, possibly acting through free-radical scavenging and quenching.247 249-251

Similarities between these findings and those with UW are apparent. Whether a CR rinse has advantages over a prereperfusion second rinse with a UW-derived, low-potassium, sodium lacto-bionate and sucrose solution used for storage is not yet established, nor is the effect of CR on other vascularized allografts yet known.

Was this article helpful?

0 0
Diabetes Sustenance

Diabetes Sustenance

Get All The Support And Guidance You Need To Be A Success At Dealing With Diabetes The Healthy Way. This Book Is One Of The Most Valuable Resources In The World When It Comes To Learning How Nutritional Supplements Can Control Sugar Levels.

Get My Free Ebook


Post a comment