Livers from non-heart-beating donors are better preserved if oxygen is provided during cold storage, researchers in Germany have demonstrated in rats. Two methods are feasible: insufflation of gaseous oxygen via the liver’s venous vascular system or pulsatile machine perfusion with histidine-tryptophan-ketoglutarate (HTK) preservation solution.
Dr. Thomas Minor, of the University of Bonn, and colleagues compared the two methods with simple cold storage in HTK. In all cases, livers were harvested from the animals 60 minutes after induced cardiac arrest, were rinsed with saline and then with HTK, and were stored for 24 hours, according to the team’s report in the June issue of Clinical Transplantation.
Upon reperfusion in vitro, portal vascular perfusion pressure was equally good in livers preserved by machine perfusion (MP) and those preserved by venous systemic oxygen persufflation (VSOP), and the pressure in these groups was better than in the control group (p<0.05). Likewise, release of alanine aminotransferase was significantly reduced, and metabolic activity of the livers was markedly improved, after MP and VSOP compared with simple cold storage.
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