Hydrophilic bile salts protect bile duct epithelium during cold preservation: A scanning electron microscopy study

Prolonged graft preservation is associated with postoperative bile duct str ictures after liver transplantation, We previously showed that hydrophilic bile salts mitigate bile duct preservation injury in a pig model. Because t his injury occurs at the epithelial level, scanning electron microscopy was performed to further characterize this effect in vitro, Swine livers were harvested after the intravenous infusion of 1 of 3 solutions: saline (n = 7 ), tautoursodeoxycholate ([TUDC] hydrophilic; n = 4), or taurodeoxycholate ([TDC] hydrophobic; n = 4), Livers were perfused with University of Wiscons in solution. The bile ducts were flushed retrograde, and the liver was stor ed at 0 degrees C to 1 degrees C for 20 hours. Bile duct samples were obtai ned at the time of harvest and 8, 12, 16, and 20 hours thereafter. In salin e-infused controls at time 0, the epithelium was intact and composed of uni form cuboidal cells covered with fine regular microvilli. There were no spa ces between individual tells. After 8 to 12 hours of preservation, cells we re more irregular in shape, with loss of cell-cell contact. The cell surfac es showed fewer microvilli, Surface erosions suggested loss of cell-wall in tegrity. TUDC was protective, evidenced by normal-appearing cells with unif orm microvilli after 16 hours. In contrast, TDC accelerated the injury proc ess, causing cell-surface erosions, blebs, and loss of microvilli as early as time 0, Scanning electron microscopy is an excellent tool to study injur y to bile duct epithelium. This study supports the hypothesis that hydrophi lic bile salts protect bile ducts during preservation. To determine whether treatment with hydrophilic bile salts can prevent postoperative stricture, in vivo transplantation studies are needed, Copyright (C) 2000 by the Amer ican Association for the Study of Liver Diseases.