title: Reduced ischemia-reoxygenation injury in rat intestine after luminal preservation with a tailored solution.
abstract: 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.
authors.affiliation: Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands. a.m.roskott@chir.umcg.nl
authors.forename: Anne Margot
authors.initials: AM
authors.lastname: Roskott
authors.forename: Vincent B
authors.initials: VB
authors.lastname: Nieuwenhuijs
authors.forename: Henri G D
authors.initials: HG
authors.lastname: Leuvenink
authors.forename: Gerard
authors.initials: G
authors.lastname: Dijkstra
authors.forename: Petra
authors.initials: P
authors.lastname: Ottens
authors.forename: Marina H
authors.initials: MH
authors.lastname: de Jager
authors.forename: Patricia
authors.initials: P
authors.lastname: Gonalves Dias Pereira
authors.forename: Vaclav
authors.initials: V
authors.lastname: Fidler
authors.forename: Geny M M
authors.initials: GM
authors.lastname: Groothuis
authors.forename: Rutger J
authors.initials: RJ
authors.lastname: Ploeg
authors.forename: Inge A M
authors.initials: IA
authors.lastname: de Graaf
mesh_terms: 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
chemical_list: 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