Hypothermic oscillating liver perfusion stimulates ATP synthesis prior to transplantation

Background. ATP and glycogen depletion often have been demonstrated during cold storage of the liver prior to transplantation. Suppression of events t hat lead to metabolic depression and to lipid peroxidation could contribute to improvement of liver preservation. A new method of liver preservation f or transplantation is therefore suggested, an oscillating oxygenated hypoth ermic liver perfusion. Methods. Biochemical analysis of liver tissue samples and perfusate after 1 0 h of perfusion by the presented oscillating perfusion model were compared with results after continuous liver perfusion for 10 h as well as with dat a derived from cold-stored livers over a period of 10 h. Particular referen ce was made to nucleotide metabolites, glycogen content, lipid peroxidation , glutathione content, glycolytic metabolites, and enzyme release before an d after preservation. Results. Glycogen depletion occurred to the same degree in hypothermic stor age and machine perfusion (oscillating as well as continuous perfusion), bu t the energy charge was significantly increased after oxygenated perfusion, whereas cold storage resulted in a significant energy charge depletion. In addition, perfusion by an oscillating technique yielded superior energy ch arge loading compared to the continuous perfusion technique and diminished the other hand lipid peroxidation. Conclusions. Hypothermic oscillating oxygenated perfusion could be importan t for the improvement of the quality of energy-depleted organs prior to tra nsplantation. (C) 1998 Academic Press.