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Initial Blood Washout During Organ Procurement Determines Liver Injury and Function After Preservation and Reperfusion
Author(s) -
't Hart Nils A.,
Van Der Plaats Arjan,
Leuvenink Henri G.D.,
WiersemaBuist Janneke,
Olinga Peter,
Van Luyn Marja J.A.,
Verkerke Gijsbertus J.,
Rakhorst Gerhard,
Ploeg Rutger J.
Publication year - 2004
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/j.1600-6143.2004.00580.x
Subject(s) - washout , medicine , perfusion , viaspan , ischemia , reperfusion injury , warm ischemia , blood pressure , anesthesia , cardiology
Organ procurement is the first step toward effective liver preservation and comprises a thorough washout of blood components from the microvasculature. To study the efficacy of optimal blood washout of the liver, three groups were compared including low‐pressure perfusion with UW‐CSS (12 mmHg, group A), which is the routine method in clinical practice, high‐pressure perfusion with UW‐CSS (100 mmHg, group B) and low‐pressure perfusion with modified UW solution (12 mmHg, group C). After procurement all livers were preserved in original UW‐CSS for 0, 24 or 48 h, followed by reperfusion in oxygenated Williams Medium E for 24 h at 37 °C. Histology results of livers procured in group A, showed good hepatocyte viability but also remaining erythrocytes. However, injury parameters were high and ATP concentrations were low. No functional differences were found. Group B, high pressure, and group C, modified UW‐CSS, both showed better results. High‐pressure washout is preferable since the warm ischemia time during procurement is short. We propose to use high‐pressure UW‐CSS perfusion for the initial blood washout of the donor liver instead of the usually used low‐pressure washout.