Optimizing the concentration of hydroxyethylstarch in a novel intestinal-specific preservation solution.
BACKGROUND
Our lab has developed an effective nutrient-rich solution that facilitates energy production and control of oxidative stress during static cold storage of the intestine; however, the requirement for oncotic agents, such as hydroxyethylstarch (HES), has not been evaluated. This study investigated the effectiveness and requirement for HES in an intraluminal preservation solution during a clinically relevant period of cold storage.


METHODS
Rat intestines were procured, including an intravascular flush with University of Wisconsin solution followed by a 'back table' intraluminal flush with a nutrient-rich preservation solution containing varying amounts of HES (n=6 per group): Group 1, 0%; Group 2, 2.5%; Group 3, 5%; Group 4, 10%. Energetics, oxidative stress, and morphology were assessed over a 24h time-course of cold storage.


RESULTS
Overall, the 5% HES solution, Group 3, demonstrated superior energetic status (ATP and total adenylates) compared to all groups, P<0.05. Malondialdehyde levels indicated a reduction in oxidative stress in Groups 3 and 4 (P<0.05). After 12h, median modified Parks' grades for Groups 2 and 3 were significantly lower than Groups 1 and 4, P<0.05.


CONCLUSIONS
Our data suggests that when employing an intraluminal preservation solution for static organ storage, oncotic support is a fundamental requirement; 5% HES is optimal.
Kokotilo
Matthew S
MS
Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.
Carter
Jodi
J
Thiesen
Aducio
A
Chen
Ming H
MH
Ochs
Angela
A
Khadaroo
Rachel G
RG
Churchill
Thomas A
TA
D000244:Adenosine Diphosphate / Q000378:metabolism; D000255:Adenosine Triphosphate / Q000378:metabolism; D000818:Animals; D015925:Cryopreservation; D006895:Hydroxyethyl Starch Derivatives / Q000008:administration & dosage*; D007421:Intestine, Small / Q000378:metabolism*; D008297:Male; D008315:Malondialdehyde / Q000378:metabolism; D019188:Organ Preservation Solutions / Q000737:chemistry*; D018384:Oxidative Stress; D051381:Rats; D017207:Rats, Sprague-Dawley
D006895:Hydroxyethyl Starch Derivatives; D019188:Organ Preservation Solutions; D008315:Malondialdehyde; D000244:Adenosine Diphosphate; D000255:Adenosine Triphosphate