Reduced ischemia-reoxygenation injury in rat intestine after luminal preservation with a tailored solution.
BACKGROUND
The intestine is extremely sensitive to ischemic preservation and reoxygenation injury. Current vascular perfusion and cold storage with University of Wisconsin (UW) solution neglect the intestinal lumen and the ongoing mucosal metabolism during hypothermia. This study was designed to test the effects of luminal preservation with an alternative preservation solution in addition to the common vascular flush with UW solution on graft viability after preservation and ex vivo reoxygenation.


METHODS
Rat intestine was preserved on ice for 6 hr in UW solution or Williams Medium E with additional buffering, impermeants, and a colloid (WMEplus) after being stapled or after flushing and filling the lumen with the respective preservation solution. Tissue slices were prepared from fresh and preserved intestines and were incubated with oxygen for 6 hr at 37°C to assess the viability after reoxygenation.


RESULTS
Directly after preservation, histologic damage was mild and unaffected by preservation strategy. Contrary to luminal preservation, closed preservation resulted in significantly decreased ATP levels compared with control. Reoxygenation aggravated damage and revealed differences between the strategies. Luminal preservation better maintained the ATP levels and histologic integrity (vs. closed preservation) for both solutions. Histomorphologic integrity was superior after preservation with WMEplus (vs. UW solution). Expression of stress responsive genes was least up-regulated in the slices from tissue preserved luminally with WMEplus.


CONCLUSIONS
In conclusion, preservation and reoxygenation injury can be attenuated by luminal preservation with WMEplus.
Roskott
Anne Margot
AM
Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands. a.m.roskott@chir.umcg.nl
Nieuwenhuijs
Vincent B
VB
Leuvenink
Henri G D
HG
Dijkstra
Gerard
G
Ottens
Petra
P
de Jager
Marina H
MH
Gonalves Dias Pereira
Patricia
P
Fidler
Vaclav
V
Groothuis
Geny M M
GM
Ploeg
Rutger J
RJ
de Graaf
Inge A M
IA
D000241:Adenosine; D000493:Allopurinol; D000818:Animals; D002470:Cell Survival; D005786:Gene Expression Regulation; D005978:Glutathione; D007053:Ice; D007328:Insulin; D007413:Intestinal Mucosa / Q000166:cytology / Q000473:pathology; D007422:Intestines / Q000166:cytology / Q000473:pathology / Q000503:physiopathology*; D007511:Ischemia / Q000517:prevention & control*; D008871:Microvilli / Q000473:pathology / Q000502:physiology; D009926:Organ Preservation / Q000379:methods*; D019188:Organ Preservation Solutions; D012333:RNA, Messenger / Q000235:genetics / Q000302:isolation & purification; D011887:Raffinose; D051381:Rats
D007053:Ice; D007328:Insulin; D019188:Organ Preservation Solutions; D012333:RNA, Messenger; C055206:University of Wisconsin-lactobionate solution; D000493:Allopurinol; D005978:Glutathione; D000241:Adenosine; D011887:Raffinose