The influence of storage temperature during machine perfusion on preservation quality of marginal donor livers.
BACKGROUND
Although non-heart-beating donors have the potential to increase the number of available organs, the livers are used very seldom because of the risk of primary non-function. There is evidence that machine perfusion is able to improve the preservation of marginal organs, and therefore we evaluated in our study the influence of the perfusate temperature during oxygenated machine perfusion on the graft quality.


METHODS
Livers from male Wistar rats were harvested after 60-min warm ischemia induced by cardiac arrest. The portal vein was cannulated and the liver flushed with Lifor (Lifeblood Medical, Inc.) organ preservation solution for oxygenated machine perfusion (MP) at 4, 12 or 21 degrees C. Other livers were flushed with HTK and stored at 4 degrees C by conventional cold storage (4 degrees C-CS). Furthermore two groups with either warm ischemic damage only or without any ischemic damage serve as control groups. After 6h of either machine perfusion or cold storage all livers were normothermic reperfused with Krebs-Henseleit buffer, and functional as well as structural data were analyzed.


RESULTS
Contrary to livers stored by static cold storage, machine perfused livers showed independently of the perfusate temperature a significantly decreased enzyme release of hepatic transaminases (ALT) during isolated reperfusion. Increasing the machine perfusion temperature to 21 degrees C resulted in a marked reduction of portal venous resistance and an increased bile production.


CONCLUSIONS
Oxygenated machine perfusion improves viability of livers after prolonged warm ischemic damage. Elevated perfusion temperature of 21 degrees C reconstitutes the hepatic functional capacity better than perfusion at 4 or 12 degrees C.
Clinic for General, Visceral and Transplantation Surgery, Charité Campus Virchow-Klinikum, University Medicine Berlin, Germany. peter.olschewski@charite.de
Peter
P
Olschewski
Paul
P
Gass
Veeravorn
V
Ariyakhagorn
Kerstin
K
Jasse
Gerhard
G
Hunold
Martin
M
Menzel
Wenzel
W
Schöning
Volker
V
Schmitz
Peter
P
Neuhaus
Gero
G
Puhl
D000818:Animals; D003080:Cold Temperature; D016031:Liver Transplantation; D008297:Male; D009926:Organ Preservation / Q000379:methods*; D019188:Organ Preservation Solutions / Q000494:pharmacology; D010477:Perfusion / Q000379:methods*; D051381:Rats; D017208:Rats, Wistar; D014019:Tissue Donors; D020858:Tissue and Organ Harvesting / Q000379:methods
D019188:Organ Preservation Solutions