Survival transplantation of preserved non-heart-beating donor rat livers: preservation by hypothermic machine perfusion.
BACKGROUND
Non-heart-beating donor (NHBD) livers are an untapped source with the potential to provide relief to the current donor shortage problem. Hypothermic machine perfusion (MP) has the potential to reclaim and preserve these marginal donor organs.


METHODS
This study compared 5-day survival in a rat NHBD liver transplantation model with simple cold storage (SCS) and MP-preserved tissues that had experienced 30 min of warm ischemia followed by a 5-hr preservation period with the University of Wisconsin solution. Total release of lactate dehydrogenase (LDH) and alanine aminotransferase (ALT) were determined at major time points. Bilirubin levels and histology were examined after 5-day survival.


RESULTS
Six of seven control livers and five of six MP livers survived, whereas SCS tissues had survival in zero of seven. The results showed that MP livers had reduced release of LDH and ALT after 5 hr of storage, 5.07+/-1.42 and 2.02+/-0.69 U (mean+/-SE), respectively, compared with SCS, 15.54+/-0.81 and 3.41.3+/-0.73 U, respectively. Bilirubin values after 5-day survival of MP livers (1.17+/-0.49 mg/dL) were comparable to controls (0.91+/-0.36 mg/dL). Histology confirms that SCS displayed increased necrosis and MP tissue showed regions of near normal hepatic structure.


CONCLUSIONS
These results suggest that MP for 5 hr improves survival and reduces cellular damage of liver tissue that has experienced 30 min of warm ischemia when compared with SCS tissues. Further studies need to be conducted, but this study suggests that MP preservation has the potential to reclaim and preserve NHBD liver tissues.
Lee
Charles Y
CY
Department of Mechanical Engineering and Engineering Science, University of North Carolina at Charlotte, Charlotte, NC 28223, USA. cyclee@uncc.edu
Jain
Shailendra
S
Duncan
Heather M
HM
Zhang
Jian X
JX
Jones
Jon W
JW
Southard
James H
JH
Clemens
Mark G
MG
D000410:Alanine Transaminase / Q000097:blood; D000818:Animals; D002102:Cadaver; D006085:Graft Survival / Q000502:physiology*; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008099:Liver / Q000166:cytology / Q000473:pathology; D016031:Liver Transplantation / Q000502:physiology*; D009926:Organ Preservation / Q000379:methods*; D010477:Perfusion / Q000295:instrumentation / Q000379:methods; D051381:Rats; D013997:Time Factors; D014019:Tissue Donors
D007770:L-Lactate Dehydrogenase; D000410:Alanine Transaminase