Subnormothermic machine perfusion protects steatotic livers against preservation injury: A potential for donor pool increase?
✍ Scribed by Mariapia Vairetti; Andrea Ferrigno; Filippo Carlucci; Antonella Tabucchi; Vittoria Rizzo; Eleonora Boncompagni; Daniele Neri; Enrico Gringeri; Isabel Freitas; Umberto Cillo
- Publisher
- John Wiley and Sons
- Year
- 2009
- Tongue
- English
- Weight
- 429 KB
- Volume
- 15
- Category
- Article
- ISSN
- 1527-6465
- DOI
- 10.1002/lt.21581
No coin nor oath required. For personal study only.
✦ Synopsis
We tested whether rat liver preservation performed by machine perfusion (MP) at 20°C can enhance the functional integrity of steatotic livers versus simple cold storage. We also compared MP at 20°C with hypothermic MP at 8°C, and 4°C. Obese and lean male Zucker rats were used as liver donors. MP was performed for 6 hours with a glucose and N-acetylcysteine-supplemented Krebs-Henseleit solution. Both MP and cold storage preserved livers were reperfused with Krebs-Henseleit solution (2 hours at 37°C). MP at 4°C and 8°C reduced the fatty liver necrosis compared with cold storage but we further protected the organs using MP at 20°C. Necrosis did not differ in livers from lean animals submitted to the different procedures; the enzymes released in steatotic livers preserved by MP at 20°C were similar to those showed in nonsteatotic organs. The adenosine triphosphate/adenosine diphosphate ratio and bile production were higher and the oxidative stress and biliary enzymes were lower in steatotic livers preserved by MP at 20°C as compared with cold storage. In livers from lean rats, the adenosine triphosphate/adenosine diphosphate ratio appears better conserved by MP at 20°C as compared with cold storage. In steatotic livers preserved by cold storage, a 2-fold increase in tumor necrosis factor-alpha levels and caspase-3 activity was observed as compared with organs preserved by MP at 20°C. These data are substantiated by better morphology, higher glycogen content, and lower reactive oxygen species production by sinusoidal cells in steatotic liver submitted to MP at 20°C versus cold storage. MP at 20°C improves cell survival and leads to a marked improvement in hepatic preservation of steatotic livers as compared with cold storage.