Relevance of warm ischemia time and perfusion conditions for the preservation of livers of non-heart beating donors

Background: In case of liver harvesting from non-heart beating donors the i nfluence of warm ischemia time and the optimal method for transplant preser vation is still unknown. Methods: With the use of real-time fluorescence microscopy, the hepatic mic rocirculation was studied during organ perfusion after different times of w arm ischemia and different application of the preservation solution. Results: Our study demonstrates that after both 30 and 60 minutes of warm i schemia, additional porto-venous perfusion of the preservation solution sig nificantly improves microvascular perfusion/preservation when compared with that after solely aortal perfusion. Conclusion: We demonstrate that warm ischemia time is an essential factor f or liver harvesting from non-heart beating donors, since deterioration of m icrovascular preservation was found significantly reduced after 30 minutes when compared with 60 minutes of warm ischemia, independent of the mode of perfusion.