The postmortem survival of tissues: The effect of time and temperature on the survival of liver as measured by glucose oxidation rate

Abstract

Summary 1. The measure of glucose oxidation rate by radio-carbon dioxide production from glucose C-14 in a standard incubation system has been employed as a method of studying the viability of liver tissues after death of the host, under varying conditions of time and temperature preservation, and by hepatic function following transplantation. 2. The rate of oxidation of glucose to CO2 is a measure of liver functional capacity that, when normal, demonstrates an entirely intact liver associated with normal histology, normal liver architecture and normal glycogen content. Levels of glucose oxidation rate that are significantly below normal are compatible with intact whole liver function after transplantation. 3. The ideal of maintenance of normal glucose oxidation rate upon incubation provides an objective toward which tissue preservation methods may be directed. 4. The use of hypothermia is effective in maintaining intact this measure of liver function. 5. Spontaneous cadaver cooling or cadaver cooling in still air in a deep freeze is unsatisfactorily slow. 6. Cooling by peritoneal lavage with or without short periods of hepatic cold perfusion is satisfactory in maintaining an intact organ histologically and an intact glucose oxidation rate. Short periods of postmortem normothermia even as transient as 30 minutes act significantly to the detriment of the tissue preservation. 7. Rapid and immediate postmortem perfusion cooling would be the clinical ideal; using this technique, in experiments of this type, we do not yet know the time limit of acceptable preservation. 8. Livers that exhibit glucose oxidation rates significantly below normal will, after whole-organ transplantation, demonstrate survival, maintain the life of the animal, and resume clinically intact liver function.