Luminal preservation of rat small intestine with University of Wisconsin or Celsior solution.
OBJECTIVE
Luminal administration of a preservation solution that prevents mucosal injury may decrease posttransplant complications. However, luminal administration of University of Wisconsin solution (UW) is controversial. In this study, we examined the potential of Celsior as a luminal small bowel preservation solution in comparison to UW or UW enriched with glutamine.


METHODS
Small bowels of six normal WagRij rats were excised and divided into six equal segments. Each segment was luminally flushed with 10 mL ice-cold UW, UW with glutamine (20 g/L) or Celsior, and stored for 0, 2.5, and 24 hours at 4 degrees C. LDH, glucose, and lactate concentrations were determined in the preservation solutions. Histologic changes were determined using the Park score.


RESULTS
Lactate dehydrogenase (LDH) was increased in all solutions after 2.5- and after 24-hour preservation. However, LDH was lower in Celsior than UW and UW with glutamine. Furthermore, higher glucose and lactate levels were found after 2.5- and 24-hour preservation in UW and UW with glutamine compared to Celsior. Histologically, jejunal segments were more susceptible to preservation than ileal segments, irrespective of the preservation solution used. Mucosal injury was evident after 2.5 hours (Park Scale 0-3) and increased significantly after 24 hours (park scale 3-6).


CONCLUSIONS
Based on the lower glucose, lactate, and LDH levels in small intestines stored in Celsior, this study suggests that Celsior is a better luminal preservation solution than UW. Unfortunately, histological evaluations still show severe mucosal injury, indicating that there is a need for better luminal preservation solutions or for concomittant intravascular delivery of a preservation solution.
Leuvenink
H G D
HG
Surgical Research Laboratory, Department of Surgery, University Hospital Groningen, Groningen, The Netherlands. h.g.d.leuvenink@chir.azg.nl
van Dijk
A
A
Freund
R L
RL
Ploeg
R J
RJ
van Goor
H
H
D000241:Adenosine; D000493:Allopurinol; D000818:Animals; D004187:Disaccharides; D004573:Electrolytes; D005947:Glucose / Q000032:analysis; D005971:Glutamates; D005978:Glutathione; D006639:Histidine; D007328:Insulin; D007421:Intestine, Small; D007770:L-Lactate Dehydrogenase / Q000032:analysis; D019344:Lactic Acid / Q000032:analysis; D008297:Male; D008353:Mannitol; D019188:Organ Preservation Solutions; D011887:Raffinose; D051381:Rats; D011919:Rats, Inbred Strains
C088453:Celsior; D004187:Disaccharides; D004573:Electrolytes; D005971:Glutamates; D007328:Insulin; D019188:Organ Preservation Solutions; C055206:University of Wisconsin-lactobionate solution; D019344:Lactic Acid; D008353:Mannitol; D006639:Histidine; D000493:Allopurinol; D007770:L-Lactate Dehydrogenase; D005978:Glutathione; D005947:Glucose; D000241:Adenosine; D011887:Raffinose