Influence of the flow rate during flushing on porcine multivisceral preservation

The effect of flushing flow rate during multiple organ procurement (MOP) on viability of the liver, pancreas, and intestine were investigated in porcine multivisceral transplantation. Splanchnic organs were flushed in situ with 50 ml/kg of 4 degrees C UW solution via the aorta using a pump at a flow rate of 10, 30, or 50 ml/kg/min. After storage and transplantation, we assessed the clearance of hyaluronic acid (CHA) for hepatic endothelial cells function, liver enzymes, amylase, and histology. Two-day survival was 17% in the 10 ml/kg/min group and 67% in other groups. The former group had inadequate flushing out of the hepatic and intestinal grafts, resulting in aggravation of CHA and intestinal tissue injury. At the flow rate of 30 ml/kg/min, the viability and integrity of all organs were well maintained. We conclude that the optimal flushing flow rate would differ for each organ, therefore the common flow rate acceptable for any of the individual grafts should be applied in MOP.