THE EFFECTS OF HEPATIC PRESERVATION AT 0-DEGREES-C COMPARED TO 5-DEGREES-C - INFLUENCE OF ANTIPROTEASES AND PERIODIC FLUSHING

The optimal preservation temperature for liver allografts is unknown. We evaluated the effect of small differences in preservation temperatu re, 5 degrees C vs 0 degrees C, on outcome of prolonged preservation. Livers of Wistar rats were preserved at these temperatures in UW solut ion for 40 h. Function was studied during reperfusion on the isolated perfused rat liver system at 37 degrees C. To compare the effects of a small reduction in temperature with known beneficial strategies, the effects of including antiproteases and periodic flushing of the graft with UW solution during cold preservation at 5 degrees C were also stu died. Aspartate transaminase (AST) and alanine transaminase release af ter 4 h of reperfusion were much higher in the livers stored at 5 than at 0 degrees C (P < 0.0005). Addition of antiproteases to the preserv ation solution or periodic flushing reduced AST release but neither tr eatment at 5 degrees C was as good as simple storage at 0 degrees C. C umulative bile production after 4 h of reperfusion was significantly g reater in the 0 degrees C preserved group than in liver at 5 degrees C or 5 degrees C with periodic flushing. The addition of antiproteases resulted in slightly increased bile production (not significant). Plat elets and WBCs in the perfusate decreased during reperfusion. This eff ect was more pronounced in the 5 degrees C preserved livers than in th ose stored at 0 degrees C. Antiproteases in the preservation solution appeared to inhibit platelet and WBC loss. Perfusate now was significa ntly higher in the 0 degrees C group. We conclude that small differenc es in preservation temperature even at these low temperatures are impo rtant in postreperfusion liver function. (C) 1994 Academic Press, Inc.