The aim of the present study was to evaluate the potential benefit of two different techniques for the provision of tissue aerobiosis upon cold preservation of marginal livers from non-heart beating donors using a recently developed improved preservation
solution. Rat livers were harvested 30 min after
cardiac arrest, flushed via the portal vein and cold-stored in HTK or modified
HTK-solution (
Custodiol-N) for 18 h at 4 degrees C. Other organs were flushed with
Custodiol-N and subjected to aerobic conditions by either vascular systemic
oxygen persufflation (VSOP) of the cold stored organ or hypothermic machine perfusion (HMP) with oxygenated
Custodiol-N. Viability of the livers was assessed after 18 h of preservation by warm reperfusion in vitro for 120 min.
Free radical mediated lipid peroxidation was significantly abrogated by the use of
Custodiol-N in all groups compared with HTK.
Custodiol-N improved
enzyme leakage upon reperfusion and histological integrity, but had no impact on functional recovery (bile production, energetic status). However, VSOP further minimized
enzyme release during the whole reperfusion period, led to a rise in hepatic bile production and enhanced recovery of energy charge (p<0.05, resp. vs
Custodiol-N). Histological appearance was concordantly improved in VSOP. During the first 45min of reperfusion, leakage of ALT and LDH was also reduced by MP but deteriorated thereafter and became significantly higher compared to
Custodiol-N at the end of the experiment. In conclusion, the results of the present study recommend the use of gaseous
oxygen persufflation to improve tissue integrity and functional recovery of predamaged livers.