title: An innovative hyperbaric hypothermic machine perfusion protects the liver from experimental preservation injury.
abstract: OBJECTIVE
  Hypothermic machine perfusion systems seem more effective than the current static storage to prevent cold ischemic liver injury. Thus, we test an innovative hyperbaric hypothermic machine perfusion (HHMP), which combines hyperbaric oxygenation of the preservation solution and continuous perfusion of the graft.
  
  
  METHODS
  Rat livers were preserved with Celsior solution according to 4 different modalities: normobaric static preservation; hyperbaric static preservation at 2 atmosphere absolute (ATA); normobaric dynamic preservation, with continuous perfusion; hyperbaric dynamic preservation, with continuous perfusion at 2 ATA. After 24 h cold preservation, we assessed different parameters.
  
  
  RESULTS
  Compared to baseline, livers preserved with the current static storage showed severe ultrastructural damage, glycogen depletion and an increased oxidative stress. Normobaric perfused livers showed improved hepatocyte ultrastructure and ameliorated glycogen stores, but they still suffered a significant oxidative damage. The addition of hyperbaric oxygen produces an extra benefit by improving oxidative injury and by inducing endothelial NO synthase (eNOS) gene expression.
  
  
  CONCLUSIONS
  Preservation by means of the present innovative HHMP reduced the liver injury occurring after the current static cold storage by lowering glycogen depletion and oxidative damage. Interestingly, only the use of hyperbaric oxygen was associated to a blunted oxidative stress and an increased eNOS gene expression.
authors.affiliation: Department of Clinical Medicine, Alma Mater Studiorum University of Bologna, 40138 Bologna, Italy.
authors.forename: Ferdinando A
authors.initials: FA
authors.lastname: Giannone
authors.forename: Davide
authors.initials: D
authors.lastname: Treré
authors.forename: Marco
authors.initials: M
authors.lastname: Domenicali
authors.forename: Ignazio
authors.initials: I
authors.lastname: Grattagliano
authors.forename: Alessandra
authors.initials: A
authors.lastname: Baracca
authors.forename: Gianluca
authors.initials: G
authors.lastname: Sgarbi
authors.forename: Caterina
authors.initials: C
authors.lastname: Maggioli
authors.forename: Pasquale
authors.initials: P
authors.lastname: Longobardi
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Solaini
authors.forename: Massimo
authors.initials: M
authors.lastname: Derenzini
authors.forename: Mauro
authors.initials: M
authors.lastname: Bernardi
authors.forename: Paolo
authors.initials: P
authors.lastname: Caraceni
mesh_terms: D000818:Animals; D004187:Disaccharides / Q000494:pharmacology; D004573:Electrolytes / Q000494:pharmacology; D015971:Gene Expression Regulation, Enzymologic; D005971:Glutamates / Q000494:pharmacology; D005978:Glutathione / Q000378:metabolism / Q000494:pharmacology; D019803:Glutathione Disulfide / Q000378:metabolism; D022781:Hepatocytes / Q000187:drug effects / Q000378:metabolism / Q000648:ultrastructure; D006639:Histidine / Q000494:pharmacology; D006931:Hyperbaric Oxygenation / Q000379:methods*; D007036:Hypothermia, Induced / Q000295:instrumentation / Q000379:methods*; D008099:Liver; D008112:Liver Glycogen / Q000378:metabolism; D008353:Mannitol / Q000494:pharmacology; D009569:Nitric Oxide / Q000378:metabolism; D052250:Nitric Oxide Synthase Type III / Q000235:genetics; D009926:Organ Preservation / Q000379:methods*; D019188:Organ Preservation Solutions / Q000494:pharmacology; D018384:Oxidative Stress / Q000187:drug effects; D010477:Perfusion; D051381:Rats; D017207:Rats, Sprague-Dawley; D015203:Reproducibility of Results; D020133:Reverse Transcriptase Polymerase Chain Reaction; D013438:Sulfhydryl Compounds / Q000378:metabolism
chemical_list: C088453:Celsior; D004187:Disaccharides; D004573:Electrolytes; D005971:Glutamates; D008112:Liver Glycogen; D019188:Organ Preservation Solutions; D013438:Sulfhydryl Compounds; D009569:Nitric Oxide; D008353:Mannitol; D006639:Histidine; D052250:Nitric Oxide Synthase Type III; D005978:Glutathione; D019803:Glutathione Disulfide