Organ Preservation with EC, HTK, and UW Solutions in Orthotopic Liver Transplantation in Syngeneic Rats. Part I: Functional Parameters

Abstract

Ischemic injury to the liver is known to influence the outcome of liver transplantation. In this study the efficacy of Euro-Collins (EC), histidine-tryptophan-ketoglutarate (HTK), and University of Wisconsin (UW) preservation solution was analyzed in the model of orthotopic liver transplantation in syngeneic rats. The study design was as follows: Group I, Euro-Collins solution (n = 11); Group II, Histidine-Tryptophan-Ketoglutarate solution (n = 11); Group III, University of Wisconsin solution (n = 11). The rat liver transplantation was performed with arterialization of the graft as described by Engemann. The postoperative follow-up was 28 days. The perfusion flow rate of the preservation solution measured during organ perfusion revealed lowest levels in the UW group and comparable levels in Groups I and II. Postoperative graft function was monitored by measuring liver enzymes (aspartate amino-transferase, ASAT, alanine aminotransferase, ALAT), bilirubin and bile production. The survival rate was 10111 in each group. Liver enzymes and bilirubin increased postoperatively and went back to normal within 2 or 3 weeks. In contrast to bilirubin, the liver enzymes showed a biphasic increase with maxima on the 1st and 5th days (range: ALAT, 220-264 U/L; ASAT, 145-177 U/L). Bile production was observed in all groups, but was significantly higher after UW-preservation (P <. 005). Analysis of inflammatory cells revealed high concentrations of intrasinusoidal leukocytes and lymphocytes in the graft with a maximum on the 5th day.