Wash-out of the non-heart-beating donor liver: a comparison between ringer lactate, HTK, and polysol.
The solution of choice for wash-out of non-heart-beating donor (NHBD) livers is histidine tryptophan ketoglutarate (HTK). This solution has a lower viscosity, due to absence of a colloid, and is less expensive as compared to the University of Wisconsin (UW) solution. A new preservation solution for machine perfusion was developed, named Polysol. In order to apply Polysol clinically in NHBD organ retrieval, the efficacy as a wash-out solution was investigated.


METHODS
After a warm ischemic time of 30 minutes, the rat liver was washed out via the portal vein with 50 mL of either ringer lactate (RL), HTK or Polysol. After wash-out and harvesting, the liver was reperfused with Krebs-Henseleit buffer. Samples were taken to assess hepatocellular injury and liver function.


RESULTS
Liver damage parameters were elevated in the RL group as compared to the HTK and Polysol groups. Liver/rat weight ratios were significantly lower after wash-out with Polysol. Overall, no differences were seen in ammonia clearance and bile production. In conclusion, wash-out of the NHBD liver with Polysol results in equal to improved reperfusion results as compared to HTK. Polysol is feasible as a wash-out solution in combination with machine perfusion using Polysol.
Bessems
M
M
Surgical Laboratory, Academic Medical Center, Amsterdam, the Netherlands. m.bessems@amc.uva.nl
Doorschodt
B M
BM
Albers
P S
PS
van Vliet
A K
AK
van Gulik
T M
TM
D000818:Animals; D005947:Glucose / Q000494:pharmacology; D006323:Heart Arrest; D007552:Isotonic Solutions / Q000494:pharmacology; D008099:Liver / Q000187:drug effects / Q000473:pathology; D008111:Liver Function Tests; D008297:Male; D008353:Mannitol / Q000494:pharmacology; D023421:Models, Animal; D019188:Organ Preservation Solutions / Q000494:pharmacology; D011189:Potassium Chloride / Q000494:pharmacology; D011343:Procaine / Q000494:pharmacology; D051381:Rats; D017208:Rats, Wistar; D015424:Reperfusion; D000077325:Ringer's Lactate; D014508:Urea / Q000378:metabolism
C039984:Bretschneider cardioplegic solution; D007552:Isotonic Solutions; D019188:Organ Preservation Solutions; D000077325:Ringer's Lactate; C504758:polysol solution; D008353:Mannitol; D011343:Procaine; D011189:Potassium Chloride; D014508:Urea; D005947:Glucose