Cellular swelling and anoxic injury of the liver

The mechanism of action of hyperosmolar solutions in organ preservation has not been fully clarified, since on the one hand they inhibit cellular swelling. However, on the other hand it seems that cellular swelling does not damage the cell. With the aim to solve this paradox, experiments were performed on isolated perfused dog livers, allowing a comparison of the consequence of swelling induced by a hypotonic perfusate with these of anoxia or of anoxia combined with swelling. Swelling alone imposed during 4 h results, after correction of the osmolarity, in a reduction of cell volume, but without signs of permanent injury. Swelling superimposed to a similar period of anoxia seems by contrast to aggravate the anoxic injury. The role of hyperosmolar solutions would thus be to interrupt the vicious circle started by anoxia, leading among other perturbations to a cellular swelling which itself potentiates the damaging effect of anoxia.