PURPOSE: We have previously reported that short oxygenated warm perfusion prior to cold preservation (SOWP) prevents warm ischemia-reperfusion injury in ex-vivo perfusion experiments using rat livers from non-heart-beating donors (NHBDs); SOWP reduced cell death in livers accompanying with improvement of mitochondrial function. In this study, we examined the effects of SOWP in rat liver transplantation from NHBDs.

METHODS: Male Wister rats were subjected to liver transplantation and divided into three groups according to the type of grafts. All grafts were stored in cold UW solution for 6 hours before transplantation. In heart-beating donor (HBD) group, liver grafts were retrieved from HBD. NHBD groups were consisted with non-treatment (NT) and SOWP groups. In these groups, grafts were retrieved 30 min after cardiac arrest induced by thoracotomy. Grafts in SOWP group were perfused with oxygenated Krebs-Henseleit buffer at 37°C for 30 min via portal vein prior to cold preservation. Pressure of perfusion was maintained at approximately 7 mmHg. For observation of survival, 6 liver transplants were performed in each group.

RESULTS: One week survival rate was 100% in HBD group. In NHBD groups, SOWP improved 0% survival in NT group to 83%. In addition, we evaluated the serum liver enzymes and histological findings one hour after reperfusion. The serum ALT, AST and LDH levels were significantly lower in both HBD group and SOWP group than in NT group (AST U/l: 1114.4 ± 212 versus 247.2 ± 215 and 493.5 ±243, respectively, p < 0.05).

CONCLUSION: SOWP should be a promising strategy for improvement of mobidity and survival in liver transplantation from NHBDs.

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