Hypothermic in situ perfusion of the porcine liver using Celsior or Ringer-lactate solution.
BACKGROUND
Hypothermic perfusion (HP) of the liver is applied during total vascular exclusion (TVE) to reduce ischemic injury during liver resection. No studies have been performed comparing different perfusion solutions for HP. The aim of this experimental study was to compare Ringer-lactate solution (RL) with Celsior solution (Cs) for HP in a pig model of 60-min TVE.


METHODS
Twenty pigs underwent 60-min TVE of the liver. Groups were TVE without HP (no-HP, n = 9), TVE with HP using RL (n = 6), and TVE with HP using Cs (n = 5). Blood and liver tissue samples were taken before TVE and during 24-h reperfusion.


RESULTS
In the no-HP group, plasma aspartate aminotransferase values were significantly increased during reperfusion (p < 0.05), while liver tissue pO(2) levels (p < 0.01) were decreased when compared to the HP groups. After 24-h reperfusion, bile production and liver tissue glutathione content were significantly higher (p < 0.05) in the Cs group (42.0 +/- 1.7 mL/h and 44.9 +/- 2.2 nmol/mg, respectively) as compared to the RL group (31.5 +/- 3.5 mL/h and 19.6 +/- 1.8 nmol/mg, respectively).


CONCLUSIONS
The protective effect of HP during TVE was confirmed in this study. HP with Cs was more effective in reducing ischemic injury as compared to HP with RL.
Dinant
S
S
Department of Surgery, Surgical Laboratory, Academic Medical Center, Amsterdam, The Netherlands. s_dinant@hotmail.com
Roseboom
H J
HJ
Levi
M
M
van Vliet
A K
AK
van Gulik
T M
TM
D000818:Animals; D001219:Aspartate Aminotransferases / Q000378:metabolism; D001706:Biopsy; D004187:Disaccharides / Q000494:pharmacology; D004573:Electrolytes / Q000494:pharmacology; D005971:Glutamates / Q000494:pharmacology; D005978:Glutathione / Q000378:metabolism / Q000494:pharmacology; D006639:Histidine / Q000494:pharmacology; D007036:Hypothermia, Induced; D007552:Isotonic Solutions / Q000494:pharmacology*; D008099:Liver / Q000098:blood supply* / Q000473:pathology; D008353:Mannitol / Q000494:pharmacology; D019188:Organ Preservation Solutions / Q000494:pharmacology*; D010101:Oxygen Consumption / Q000187:drug effects; D010477:Perfusion; D011517:Prothrombin Time; D015427:Reperfusion Injury / Q000473:pathology*; D000077325:Ringer's Lactate; D013552:Swine
C088453:Celsior; D004187:Disaccharides; D004573:Electrolytes; D005971:Glutamates; D007552:Isotonic Solutions; D019188:Organ Preservation Solutions; D000077325:Ringer's Lactate; D008353:Mannitol; D006639:Histidine; D001219:Aspartate Aminotransferases; D005978:Glutathione