24-h storage of pig livers in UW, HTK, hydroxyethyl starch, and saline solution: is microdialysis an appropriate method for the continuous graft monitoring during preservation?
Recent studies demonstrate the feasibility of microdialysis to monitor metabolism in ischemic livers. Whether these parameters correlate with markers of liver cell integrity in an experimental model using pig livers and different preservation solutions was an aim of this study. Pig livers were flushed with either 4 degrees C Histidine-Typtophan-Ketoglutarate solution (HTK) (Custodiol), University of Wisconsin solution (ViaSpan), and hydroxyethyl starch, or 12 degrees C saline solution. After 24-h storage, the livers were rinsed with saline to measure liver enzymes and lactate from the effluate. Utilizing microdialysis, intraparenchymal lactate, pyruvate, glucose, and glycerol was monitored. Tissue biopsies were taken for histological examinations. Cold preservation resulted in a decrease of metabolic activity measured by intrahepatic glucose, lactate, and pyruvate levels, as well as lactate in the effluate, independently of the solution used. Of particular interest, glycerol levels partially reflected the extent of hepatocellular damage and liver enzyme release. Glycerol levels partially discriminated preservation of different quality and were in accordance to histological findings and liver enzyme release. Lactate, pyruvate, and glucose levels were not appropriate as markers during cold storage. Whether or not glycerol monitoring could represent an additional and rational complementation to the current practice of macroscopic, microscopic and donor evaluation has to be clarified by further studies.
Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Charité Campus Virchow-Klinikum, Humboldt-Universität, Berlin, Germany. gero.puhl@charite.de
Gero
G
Puhl
Peter
P
Olschewski
Wenzel
W
Schöning
Ulf
U
Neumann
Daniel
D
Sredznizki
Anja
A
Dankof
Utz
U
Settmacher
Peter
P
Neuhaus
D000241:Adenosine; D000493:Allopurinol; D000818:Animals; D001219:Aspartate Aminotransferases / Q000378:metabolism; D003080:Cold Temperature; D005947:Glucose / Q000378:metabolism; D005978:Glutathione; D005990:Glycerol / Q000378:metabolism; D006895:Hydroxyethyl Starch Derivatives; D066298:In Vitro Techniques; D007328:Insulin; D007770:L-Lactate Dehydrogenase / Q000378:metabolism; D019344:Lactic Acid / Q000378:metabolism; D008099:Liver / Q000378:metabolism* / Q000473:pathology; D008297:Male; D008353:Mannitol; D017551:Microdialysis; D008991:Monitoring, Physiologic / Q000379:methods; D009926:Organ Preservation / Q000379:methods*; D019188:Organ Preservation Solutions; D011189:Potassium Chloride; D011343:Procaine; D019289:Pyruvic Acid / Q000378:metabolism; D011887:Raffinose; D012965:Sodium Chloride; D034421:Sus scrofa
C039984:Bretschneider cardioplegic solution; D006895:Hydroxyethyl Starch Derivatives; D007328:Insulin; D019188:Organ Preservation Solutions; C055206:University of Wisconsin-lactobionate solution; D019344:Lactic Acid; D008353:Mannitol; D012965:Sodium Chloride; D011343:Procaine; D000493:Allopurinol; D011189:Potassium Chloride; D019289:Pyruvic Acid; D007770:L-Lactate Dehydrogenase; D001219:Aspartate Aminotransferases; D005978:Glutathione; D005947:Glucose; D000241:Adenosine; D011887:Raffinose; D005990:Glycerol