[Mitochondrial energy synthesis during cold preservation and after reperfusion in liver transplantation]

In liver transplantation, primary graft nonfunction (PGN) occurred 5 to 10% in all cases. For preventing PGN it is necessary to elucidate a reliable assessment procedure for graft function before transplantation. In addition, methods of harvest or preservation which can maintain good viability of the graft are also needed. The purpose of this study is to clarify whether mitochondrial respiratory ratio (RCR), which is ability of ATP synthesis, is a reliable marker of the graft viability and whether a harvesting method with an artificial heart and lung is effective for keeping high energy synthesis of mitochondria or not. Pigs were used for this study. In a standard harvest method RCR decreased gradually during cold preservation. Grafts with values of RCR more than 3.0 had good function after transplantation. RCR depended on mitochondrial ATP, not tissue ATP. Grafts harvested with artificial heart and lung kept RCR more than 4.0 at 12 hours after preservation. Five of 6 pigs transplanted 12 hours preserved liver harvested from the donor with an artificial heart and lung survived more than 5 days. These results suggested that mitochondrial ATP synthesis has strong relation to PGN and RCR is a reliable marker for graft viability.