Optimising post-conditioning time of marginal donor livers.
BACKGROUND
Due to the discrepancy between organ donors and receptors, the use of marginal livers (e.g., non-heart-beating-donor grafts) for transplantation purpose increased. The potential of a short-term aerobic machine perfusion (post-conditioning) for "less than optimal" grafts after cold storage (CS) was recently demonstrated. In our study, the optimal time course of post-conditioning (PC) is to be evaluated.


METHODS
Livers from male Wistar rats were withdrawn 30 min after cardiac arrest and flushed with histidine tryptophan ketoglutarate (HTK) solution. Then they were stored in HTK at 4 degrees C for 18 h. After 16 h, some livers were put on PC by cold perfusion with HTK for 0.5, 1, 2 or 3 h. Afterwards, the viability of the organs was estimated by warm reperfusion (2 h) in vitro.


RESULTS
After 1 h of PC, a significant increase in bile production and a decrease in enzyme release could be detected in comparison to CS. The adenosine triphosphate content of the PC livers after 1 h of treatment was significant higher than in CS organs. No markers for apoptosis could be detected after 1 h PC.


CONCLUSIONS
It can be concluded that a PC of 1 h after cold storage can ameliorate the organ viability of marginal livers. The extension or abbreviation of PC time seems to have no further beneficial effects.
Manekeller
Steffen
S
Department of Surgery, Faculty of Medicine, Rheinische Friedrich-Wilhelms-Universität, Bonn, Germany. Steffen.Manekeller@ukb.uni-bonn.de
Seinsche
Alexandra
A
Stegemann
Judith
J
Hirner
Andreas
A
D000641:Ammonia / Q000378:metabolism; D000818:Animals; D017209:Apoptosis / Q000502:physiology; D002102:Cadaver; D006085:Graft Survival / Q000502:physiology; D020287:In Situ Nick-End Labeling; D008099:Liver / Q000098:blood supply* / Q000473:pathology; D008111:Liver Function Tests; D016031:Liver Transplantation / Q000379:methods* / Q000473:pathology; D008297:Male; D009926:Organ Preservation / Q000379:methods*; D010100:Oxygen / Q000097:blood; D010101:Oxygen Consumption / Q000502:physiology; D010477:Perfusion / Q000379:methods*; D051381:Rats; D017208:Rats, Wistar; D013696:Temperature; D014655:Vascular Resistance / Q000502:physiology
D000641:Ammonia; D010100:Oxygen