The evaluation of the isolated perfused liver as a model for the assessment of liver preservation.
An ex vivo isolated perfused porcine liver model was tested to assess its suitability for rapid, reliable and relatively cheap testing of organ preservation solutions for liver transplantation. The model consists of a machine driven recirculating system incorporating an organ chamber, blood pump and membrane oxygenator. Autologous blood was used for perfusion for a period of 2 h at a temperature of 37 degrees C. The model was tested with five groups of livers which had sustained varying degrees of injury ranging from minimally damaged to those known to be incapable of sustaining life when used for liver transplantation. The groups of livers were: (i) controls; (ii) preserved in University of Wisconsin solution (UW) for 6 h; (iii) preserved in an albumin-based extracellular fluid (ALB) for 6 h; (iv) preserved in UW for 18 h; and (v) preserved in ALB for 18 h. Bile production was found to be a reliable parameter of preservation damage. Changes in perfusate levels of aspartate aminotransferase, potassium, glucose and calcium also occurred in relationship to preservation damage. In contrast, weight gain of the liver, sequestration of the white cells and platelets in the liver, urea production and oxygen consumption were unreliable predictors of liver damage. Histology of biopsy specimens revealed apparently well preserved livers in all cases after preservation but before perfusion, but serious abnormalities after perfusion in long preserved livers, with features in these suggestive of damage to the sinusoidal endothelium. We believe that the model is a worthwhile adjunct to research into liver preservation.
Bell
R
R
Department of Surgery, University of Sydney, New South Wales, Australia.
Shiel
A G
AG
Dolan
P
P
Mears
D C
DC
Woodman
K
K
D000241:Adenosine; D000418:Albumins; D000493:Allopurinol; D000818:Animals; D005260:Female; D005978:Glutathione; D066298:In Vitro Techniques; D007328:Insulin; D008099:Liver / Q000503:physiopathology*; D016031:Liver Transplantation; D009926:Organ Preservation / Q000295:instrumentation / Q000379:methods*; D019188:Organ Preservation Solutions; D009929:Organ Size; D010477:Perfusion / Q000295:instrumentation / Q000379:methods; D011887:Raffinose; D012996:Solutions; D013552:Swine; D013997:Time Factors
C080553:ALB solution; D000418:Albumins; D007328:Insulin; D019188:Organ Preservation Solutions; D012996:Solutions; C055206:University of Wisconsin-lactobionate solution; D000493:Allopurinol; D005978:Glutathione; D000241:Adenosine; D011887:Raffinose