title: Interstitial accumulation of Na+ and K+ during flush-out and cold storage of rat livers: implications for graft survival.
abstract: Intracellular-type electrolyte solutions were introduced into organ preservation to prevent K+ efflux and Na+ and Cl- influx into cells and cell swelling during cold ischemia. We studied cation accumulation in the interstitial space by microdialysis, during rat liver cold storage and after flush-out with high-K+ and low-K+ solutions. The effect of Na+ and K+ on graft function and survival was studied in an isolated perfused liver model and an orthotopic transplantation model after rat liver storage in iso-osmolar high-K+ and low-K+ solutions. After 24 hours of cold ischemia [Na+]o dropped from 136 +/- 2 mmol/L to 91.8 +/- 1.1 mmol/L, and [K+]o increased from 5.9 +/- 0.1 mmol/L to 12.2 +/- 1.6 mmol/L (P < .001 vs. control). [Na+]o and [K+]o after flush-out did not equilibrate with [Na+]sol and [K+]sol after 24 hours of cold storage. Rat livers preserved in low-K+ solutions produced significantly more bile during isolated reperfusion and released less alanine transaminase, aspartate transaminase, and lactate dehydrogenase into the reperfusion medium than high-K+ solutions. Rat liver survival after 14 hours of preservation was higher in low-K+ solutions (13 of 13) than in high-K+ solutions (7 of 13). Those studies indicate that during cold storage of rat livers, transmembraneous Na+-K+ sodium-potassium exchange might not follow the 3:2 stochiometry of a sole sodium-potassium exchange via Na+-K+ sodium-potassium adenosine triphosphatase (ATPase), and that low-K+ solutions might improve graft function and survival after rat liver preservation.
authors.affiliation: Department of Visceral and Transplant Surgery, University of Bern, Inselspital, Bern, Switzerland.
authors.forename: Y h
authors.initials: Yh
authors.lastname: Tian
authors.forename: C
authors.initials: C
authors.lastname: Fukuda
authors.forename: M K
authors.initials: MK
authors.lastname: Schilling
mesh_terms: D000818:Animals; D003080:Cold Temperature; D006085:Graft Survival; D007511:Ischemia / Q000378:metabolism; D008099:Liver / Q000098:blood supply / Q000378:metabolism*; D016031:Liver Transplantation; D008297:Male; D017551:Microdialysis; D009926:Organ Preservation; D010477:Perfusion; D011188:Potassium / Q000008:administration & dosage / Q000378:metabolism*; D051381:Rats; D017208:Rats, Wistar; D012964:Sodium / Q000378:metabolism*; D012996:Solutions; D013997:Time Factors
chemical_list: D012996:Solutions; D012964:Sodium; D011188:Potassium