Preservation damage in liver transplantation. Influence of rapid cooling

Liver preservation and transplantation was performed in pigs. For flush perfusion cold (2 degrees C) and warm (15 degrees C) lactated Ringer's solution were compared. Administration of cold Ringer's resulted in a severe endothelial damage of sinusoids that was aggravated after recirculation, as shown by electron microscopic examination. Using warm Ringer's solution this alteration was limited. Liver parenchymal cells are impaired mainly during reflow as a consequence of microcirculatory disturbance. After cold flushing animals died within a few hours, whereas after flushing with warm Ringer's solution pigs survived definitively.