Organ Preservation with EC, HTK, and UW Solutions in Orthotopic Liver Transplantation in Syngeneic Rats. Part I: Functional Parameters

Abstract

Ischemic injury to the liver is known to influence the outcome of liver transplantation. In this study the efficacy of Euro-Collins (EC), histidine-tryptophan-ketoglutarate (HTK), and University of Wisconsin (UW) preservation solution was analyzed in the model of orthotopic liver transplantation in syngeneic rats. The study design was as follows: Group I, Euro-Collins solution (n = 11); Group II, Histidine-Tryptophan-Ketoglutarate solution (n = 11); Group III, University of Wisconsin solution (n = 11). The rat liver transplantation was performed with arterialization of the graft as described by Engemann. The postoperative follow-up was 28 days. The perfusion flow rate of the preservation solution measured during organ perfusion revealed lowest levels in the UW group and comparable levels in Groups I and II. Postoperative graft function was monitored by measuring liver enzymes (aspartate amino-transferase, ASAT, alanine aminotransferase, ALAT), bilirubin and bile production. The survival rate was 10/11 in each group. Liver enzymes and bilirubin increased postoperatively and went back to normal within 2 or 3 weeks. In contrast to bilirubin, the liver enzymes showed a biphasic increase with maxima on the 1st and 5th days (range: ALAT, 220-264 U/L; ASAT, 145-177 U/L). Bile production was observed in all groups, but was significantly higher after UW-preservation (P < .005). Analysis of inflammatory cells revealed high concentrations of intrasinusoidal leukocytes and lymphocytes in the graft with a maximum on the 5th day.

Efficacy of liver graft washout as a function of the perfusate, pressure, and temperature

“…[30][31][32][33][34] Although rats do not have a gallbladder, a pinhole collimator-equipped camera revealed radioactive bile being excreted into the duodenum after approximately 20 minutes in our experiments. With a mean bile flow of 0.6 lL/g of liver/minute in rats, 35 accumulation in the intrahepatic biliary tract occurred before visualization by the pinhole camera; as a result, higher residual radioactivity could be found in the liver after washout.…”

Preservation Solutions Alter Mrp2-Dependent Bile Flow in Cold Ischemic Rat Livers

“…The graft survival rate is lower in HTK than in UW when the cold ischemic time is longer than 10 hours [16]. Decreased bile production and hyperbilirubinemia appeared to be more marked in grafts stored in HTK [16,17].…”

Protective Effects of Ambroxol in Hypothermic Liver Preservation: A Transplant Study

“…Histological slides stained with hematoxylin and eosin and processed by Goldner's method were scored semiquantitatively according to the extent of pathological changes including the formation of cell edema, intralobular necroses, fatty degeneration, and periportal in ammation, and the activation of Kupffer cells [6]. The degree of damage was expressed in percentage terms: none ( = 0 points or 0%), mild ( = 1 point or · 33%), moderate ( = 2 points or · 66%) and severe ( = 3 points or · 100%) injury.…”