EFFECTS OF COLD ISCHEMIA TIME ON THE GRAFT AFTER ORTHOTOPIC LIVER-TRANSPLANTATION - A BILE CYTOLOGICAL STUDY

We conducted a daily analysis of bile cellularity in 16 orthotopic liv er transplant patients fitted with a T-tube, and correlated the cytolo gical parameters (number of cells per slide, and percentage of differe nt cell types) with the duration of cold ischemia time (CIT). Two grou ps were established: one comprised patients whose CIT was less than 7 hr (CIT averaged 345 min) and the other comprised patients with a CIT of more than 7 hr (CIT averaged 505 min). The control group consisted of 15 patients who had received cholecystectomy for biliary lithiasis and were fitted with a T-tube, All 3 groups showed the highest cell de nsity on the Ist postoperative day (control: 53.3+/-15.5 cells/slide; short ischemia: 70+/-21.4 cells/slide; long ischemia: 158.8+/-53.2 cel ls/slide), which steadily decreased to disappear by day 4-5. The short ischemia group showed a higher cell density than did the control grou p for the first 2 days, although this was not significant, The long is chemia group showed the highest cell density, although only significan tly for the first 2 days when compared with the controls, and basicall y at the expense of a increase in ductal epithelial cells, Our results show that prolonged cold ischemia causes an increase in bile cell den sity at the expense of ductal epithelial cells: the longer the preserv ation time, the greater the increase.