Forty-Eight-Hour Preservation of the Canine Liver

Sung, David; Woods, John E.

doi:10.1097/00000658-197404000-00007

Cited by 14 publications

(1 citation statement)

References 8 publications

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“…Under experimental conditions, it is possible to reduce the period, of so-called "warm" ischaemia to 0, and in this way, for instance Sung et al succeeded in achieving a 48h conservation [30]. In case of human liver transplantations "warm ischaemia" is unavoidable, those safe preservations are not longer than 5 to 6 h [6,21,29].…”

Section: Introductionmentioning

confidence: 99%

Effect of ischaemia on the enzyme activity of the hepatic tissue

1977

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The lactate and pyruvate levels, as well as acid and alkaline phosphatase, lactate dehydrogenase, glucose-6-phosphate dehydrogenase, glutaminic acid-oxalacetic acid transaminase and aldolase levels of rat liver homogenizates were measured at 24 degrees C and 38 degrees C during 120 min ischaemia from 0 to the 120th min. With the exception of transaminase and aldolase, the other enzymes were also enzyme-histochemically studied. The early lesions of the liver can be detected, both the quantitative laboratory tests and enzyme histochemical studies. The deviations from normal, observed at 24 degrees C between the 60th and 100th min, and at 38 degrees C between the 30th and 60th min, might be signs of irreversible lesions. Fractionated study of the liver homogenizate improves the assessability of enzyme determinations. In the course of "warm" ischaemia, the liver lysosomal lesions are early symptoms. Parallel to the breakdown of aerobic glycolysis lactic acid, fermentation, and an active pentose phosphate cycle can be detected. Quantitative testing of the liver homogenizate and enzyme histochemical observation of the hepatic tissue, might be a suitable method for the assessment of ischaemic liver lesions.

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Section: Introductionmentioning

confidence: 99%

Effect of ischaemia on the enzyme activity of the hepatic tissue

1977

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Hepatic transplantation survival: Correlation with adenine nucleotide level in donor liver

et al. 1988

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The hypothesis was tested that human donor livers with higher ATP content and energy charge achieve better results after hepatic transplantation. Biopsies were obtained from 25 donor livers immediately prior to implantation and analyzed for adenine nucleotides using high-performance liquid chromatography. The results were correlated with organ histology, transplant function and outcome. Significantly higher concentrations of ATP (4.22 +/- 2.87 vs. 0.71 +/- 0.69 nmoles per mg protein, p less than 0.01), ADP (8.75 +/- 2.96 vs. 4.49 +/- 1.95 nmoles per mg protein, p less than 0.01) and energy charge (0.43 +/- 0.15 vs. 0.21 +/- 0.04, p less than 0.02) were found in successful (n = 20) relative to failed (n = 5) livers. No significant differences were found in AMP, xanthine or hypoxanthine for the two groups, although the average values were higher in failed livers. Fifteen recipients with liver ATP concentration above 2 nmoles per mg protein and energy charge above 0.3 recovered well. Five other successful patients with lower ATP concentration (0.70 +/- 0.39 nmoles per mg protein) and energy charge (0.20 +/- 0.03) had postoperative courses complicated by infection or prolonged hyperbilirubinemia. In five patients whose livers failed, all had low ATP content and energy charge. Of these, three received a replacement liver and two died shortly after the transplantation. The study demonstrates a direct correlation between high ATP content and good posttransplant outcome.

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Liver preservation: The past and the future

Blankensteijn

Terpstra

1991

Hepatology

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The ultimate objective of organ preservation is unrestricted and immediate graft function after a transplant under optimal conditions in the most suitable recipient. This means that time and efficacy are the basic features of the search for the ideal preservation method. Theoretically, freezing and continuous aerobic perfusion are the only means of obtaining truly long-term preservation (from a month to years). From a clinical point of view, however, the preferred method of preserving livers for brief periods before transplantation is simple cold storage (1).Until recently, cold storage of the graft in Collins' solution provided acceptable graft function when preservation time was 8 hr or less (2). Still, in the first report of the European Liver Transplant Registry (31, reviewing 1,315 liver transplantations performed at 32 different centers from 1968 to 1987, one of the principal causes of loss of the graft (and occasionally of death of the patient) appeared to be the so-called "primary nonfunction" of the liver. In most cases this was thought to be through an injury caused by inadequate preservation. To keep the period of cold storage to a minimum, close coordination of two full surgical teams -one for the donor and one for the recipient -was necessary, and the recipient operation had to be performed as an emergency procedure, often at night. Furthermore, only a very narrow margin of safety existed in the storage time, in case of unforeseen delays or unanticipated, timeconsuming difficulty in the recipient operation.To evaluate the possibility of liver transplantation on a (semi-) elective basis, Belzer (4) looked at the clinical needs for preservation times and concluded that 12 to 18 hr was necessary for liver transplantation to be performed electively.Similar to kidney transplantation, (semi-) elective liver transplantation will yield substantial benefits: because simultaneous donor and recipient operations are not required, an unnecessary recipient laparotomy may be prevented if the donor organ appears unsuitable for transplantation. Furthermore, if laparotomy findings indicate that the recipient is unsuitable for

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Forty-Eight-Hour Preservation of the Canine Liver

Cited by 14 publications

References 8 publications

Effect of ischaemia on the enzyme activity of the hepatic tissue

Effect of ischaemia on the enzyme activity of the hepatic tissue

Hepatic transplantation survival: Correlation with adenine nucleotide level in donor liver

Liver preservation: The past and the future

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