title: Efficacy of liver graft washout as a function of the perfusate, pressure, and temperature.
abstract: Donor graft washout can be impaired by colloids in organ preservation solutions that increase the viscosity and agglutinative propensity of red blood cells (RBCs) and potentially decrease organ function. The colloid-induced agglutinative effects on RBCs and RBC retention after liver washout with Ringer's lactate (RL), histidine tryptophan ketoglutarate solution, University of Wisconsin solution, and Polysol were determined as a function of the washout pressure (15 or 100 mm Hg) and temperature (4 or 37°C) in a rat liver washout model with (99m) Tc-pertechnetate-labeled RBCs. Colloids (polyethylene glycol in Polysol and hydroxyethyl starch in University of Wisconsin) induced RBC agglutination, regardless of the solution's composition. RL was associated with the lowest degree of (99m) Tc-pertechnetate-labeled RBC retention after simultaneous arterial and portal washout at 37°C and 100 mm Hg. RL washout was also associated with the shortest washout time. A single portal washout with any of the solutions did not result in differences in the degree of RBC retention, regardless of the temperature or pressure. In conclusion, no differences were found in portal washout efficacy between colloidal solutions, histidine tryptophan ketoglutarate, and RL. Simultaneous arterial and portal washout with RL at 37°C and 100 mm Hg resulted in the least RBC retention and the shortest washout time.
authors.affiliation: Department of Surgery (Surgical Laboratory), Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: Ivo C J H
authors.initials: IC
authors.lastname: Post
authors.forename: Marcel C
authors.initials: MC
authors.lastname: Dirkes
authors.forename: Michal
authors.initials: M
authors.lastname: Heger
authors.forename: Joanne
authors.initials: J
authors.lastname: Verheij
authors.forename: Kora M
authors.initials: KM
authors.lastname: de Bruin
authors.forename: Dirk
authors.initials: D
authors.lastname: de Korte
authors.forename: Roelof J
authors.initials: RJ
authors.lastname: Bennink
authors.forename: Thomas M
authors.initials: TM
authors.lastname: van Gulik
mesh_terms: D000241:Adenosine / Q000737:chemistry; D000493:Allopurinol / Q000737:chemistry; D000818:Animals; D003102:Colloids / Q000737:chemistry; D004903:Erythrocyte Aggregation; D004912:Erythrocytes / Q000187:drug effects; D005947:Glucose / Q000737:chemistry; D005978:Glutathione / Q000737:chemistry; D007328:Insulin / Q000737:chemistry; D007552:Isotonic Solutions / Q000737:chemistry; D008099:Liver / Q000187:drug effects / Q000378:metabolism; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D008353:Mannitol / Q000737:chemistry; D008853:Microscopy; D009926:Organ Preservation / Q000379:methods*; D019188:Organ Preservation Solutions / Q000737:chemistry; D011189:Potassium Chloride / Q000737:chemistry; D011343:Procaine / Q000737:chemistry; D019275:Radiopharmaceuticals / Q000737:chemistry; D011887:Raffinose / Q000737:chemistry; D051381:Rats; D017208:Rats, Wistar; D000077325:Ringer's Lactate; D013670:Sodium Pertechnetate Tc 99m / Q000737:chemistry; D013696:Temperature
chemical_list: C039984:Bretschneider cardioplegic solution; D003102:Colloids; D007328:Insulin; D007552:Isotonic Solutions; D019188:Organ Preservation Solutions; D019275:Radiopharmaceuticals; D000077325:Ringer's Lactate; C055206:University of Wisconsin-lactobionate solution; C504758:polysol solution; D008353:Mannitol; D011343:Procaine; D000493:Allopurinol; D011189:Potassium Chloride; D013670:Sodium Pertechnetate Tc 99m; D005978:Glutathione; D005947:Glucose; D000241:Adenosine; D011887:Raffinose