Hypothermic machine perfusion of rat livers preserves endothelial cell function

Area of Science:

• Organ transplantation
• Surgical preservation
• Biomedical engineering

Background:

• Hypothermic machine perfusion (HMP) is an advanced technique for organ preservation.
• The composition of preservation solutions, such as the University of Wisconsin (UW) solution, is critical for maintaining organ viability.
• The role of oncotic agents like starch in HMP requires further investigation.

Purpose of the Study:

• To evaluate the impact of starch in the UW solution during HMP on liver function and viability.
• To compare the efficacy of HMP with starch-containing UW solution against starch-free HMP and static cold storage (SCS).

Main Methods:

• Isolated rat livers were subjected to 24-hour preservation using three methods: HMP with UW solution (HMP + starch), HMP with modified UW solution lacking starch (HMP - starch), and SCS.
• Post-preservation, livers underwent 30 minutes of warm reperfusion with functional assessments.
• Key indicators included lactate dehydrogenase (LDH) levels, bile production, hyaluronic acid uptake, albumin transit time, liver wet/dry ratio, and histological analysis.

Main Results:

• Livers preserved with HMP + starch showed significantly lower LDH levels and higher bile production.
• Endothelial cell function was improved in the HMP + starch group, evidenced by enhanced hyaluronic acid uptake and faster albumin transit.
• Reduced liver edema and better histological integrity were observed in the HMP + starch group compared to HMP - starch and SCS groups.

Conclusions:

• Hypothermic machine perfusion using the UW solution with starch offers superior liver preservation compared to SCS and starch-free HMP.
• Starch inclusion in the preservation solution enhances endothelial cell function and mitigates hepatocellular damage.
• Oncotic support provided by starch appears crucial for maintaining hepatic microcirculation during HMP.