title: Correlation between the liver temperature employed during machine perfusion and reperfusion damage: role of Ca2+.
abstract: This study compares the effects of machine perfusion (MP) at different temperatures with simple cold storage. In addition, the role of Ca(2+) levels in the MP medium was evaluated. For MP, rat livers were perfused for 6 hours with Krebs-Henseleit (KH) solution (with 1.25 or 2.5 mM CaCl(2)) at 4 degrees C, 10 degrees C, 20 degrees C, 25 degrees C, 30 degrees C, or 37 degrees C. For cold storage, livers were perfused in situ and preserved with Celsior solution at 4 degrees C for 6 hours. The reperfusion period (2 hours at 37 degrees C) was performed under the same conditions used for MP-preserved and cold storage-preserved livers. Hepatic enzyme release, bile production, adenosine triphosphate (ATP) levels, and morphology were evaluated during MP and reperfusion. MP at 37 degrees C caused marked enzyme release; the same findings were obtained during reperfusion. By contrast, MP temperature lowering induced a significant decrease in liver damage. High levels of biliary gamma-glutamyltransferase and lactate dehydrogenase were found with MP at 4 degrees C and 10 degrees C but not with MP at 20 degrees C. When a KH-1.25 mM CaCl(2) solution was used during MP at 20 degrees C, very low enzyme release was observed and significantly lower hepatic damage was present at the end of the reperfusion period in comparison with cold storage. The same results were obtained when ruthenium red, a calcium uniporter blocker, was added to KH-2.5 mM CaCl(2). ATP levels were higher and morphology was better in liver preserved with KH-1.25 mM CaCl(2). MP at 20 degrees C with KH-1.25 mM CaCl(2) resulted in better quality liver preservation, improving hepatocyte and endothelial biliary cell survival, in comparison with cold storage. This raises the need to reconsider the temperature and calcium levels to be used during liver MP.
authors.affiliation: Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy. vairetti@botta.unipv.it
authors.forename: Mariapia
authors.initials: M
authors.lastname: Vairetti
authors.forename: Andrea
authors.initials: A
authors.lastname: Ferrigno
authors.forename: Vittoria
authors.initials: V
authors.lastname: Rizzo
authors.forename: Eleonora
authors.initials: E
authors.lastname: Boncompagni
authors.forename: Amedeo
authors.initials: A
authors.lastname: Carraro
authors.forename: Enrico
authors.initials: E
authors.lastname: Gringeri
authors.forename: Gloria
authors.initials: G
authors.lastname: Milanesi
authors.forename: Sergio
authors.initials: S
authors.lastname: Barni
authors.forename: Isabel
authors.initials: I
authors.lastname: Freitas
authors.forename: Umberto
authors.initials: U
authors.lastname: Cillo
mesh_terms: D000255:Adenosine Triphosphate / Q000378:metabolism; D000818:Animals; D001219:Aspartate Aminotransferases / Q000032:analysis; D001331:Automation; D002118:Calcium / Q000494:pharmacology*; D002122:Calcium Chloride / Q000494:pharmacology; D007260:Infusion Pumps; D007770:L-Lactate Dehydrogenase / Q000032:analysis; D008099:Liver / Q000187:drug effects / Q000502:physiology* / Q000503:physiopathology; D008102:Liver Circulation / Q000502:physiology; D008297:Male; D023421:Models, Animal; D051381:Rats; D017208:Rats, Wistar; D015424:Reperfusion / Q000379:methods*; D015427:Reperfusion Injury / Q000503:physiopathology*; D013696:Temperature
chemical_list: D000255:Adenosine Triphosphate; D007770:L-Lactate Dehydrogenase; D001219:Aspartate Aminotransferases; D002122:Calcium Chloride; D002118:Calcium