Influence of perfusate on liver viability during hypothermic machine perfusion

摘要: AIM: To optimize the perfusates used for hypothermic machine perfusion (HMP). METHODS: Sprague-Dawley rats were assigned randomly to three groups (n = 12 per group) that received either saline, University of Wisconsin cold-storage solution (UW) or histidine-tryptophan-ketoglutarate (HTK) as perfusate. Each group was divided into two subgroups: static cold storage (SCS) and HMP 6 subgroup). The liver graft retrieved according method described by Kamada. For SCS group, directly placed perfusate (0-4 °C) h after isolation while portal vein connected group. Then collected at different time points analysis aspartate aminotransferase (AST), alanine transaminase (ALT) lactate dehydrogenase (LDH) levels. Liver tissues obtained evaluation histology, dry/wet weight (D/W) ratio, malondialdehyde (MDA) adenosine-triphosphate (ATP) pressure velocity monitored in real all subgroups. RESULTS: Comparison SCS: Regardless perfusate, improved architecture donor reducing congestion around sinusoids central maintaining sinusoid lining morphology; function terms ALT, AST LDH, especially during 3-6 period (SCS vs using saline: ALT3, 225.00 ± 105.62 49.50 18.50, P 0.047; LDH3, 1362.17 563.30 325.75 147.43, 0.041; UW: LDH6, 2880.14 948.46 2135.00 174.27, 0.049; HTK, AST6, 307.50 52.95 185.20 20.46, 0.041); decreased MDA level (saline, 2.79 0.30 1.09 0.09, 0.008; UW, 3.01 0.77 1.23 0.68, 0.005; 3.30 0.52 1.56 0.22, 0.006). among HTK showed less resistance than UW saline (vs 3.41 0.49 5.00 0.38, < 0.001; 4.52 0.63, 0.007); reduced edema most efficiently 0.68 0.02 0.79 0.05, 0.013), maintained ATP levels best 622.60 29.11 327.43 44.66, 301.80 37.68, 0.001). CONCLUSION: is superior both grafts. Further, found be optimal HMP.