The effects of various organ preservation solutions on hepatocyte membranepotentials, intracellular calcium concentrations, and outcome following liver transplantation
Aj. Cohen et al., The effects of various organ preservation solutions on hepatocyte membranepotentials, intracellular calcium concentrations, and outcome following liver transplantation, AM J SURG, 179(2), 2000, pp. 154-160
BACKGROUND: Hepatocyte membrane potential differences (PDs) may be altered
by the preservation solutions used in liver transplantation. Such alteratio
ns could impact on the survival of the donor liver, extent of biochemical i
njury, and flux of important ionic compounds, The purpose of the present st
udy was to document these outcomes in the presence of four different presen
tation solutions.
METHODS: Livers of adult male Sprague-Dawley rats (N = 3 to 4 per group) we
re impaled with intracellular microelectrodes prior to and at various time
periods for 6 hours following complete hepatic resection, Just prior to res
ection, each liver was perfused with preservation solutions associated with
high (normal saline [NS]), moderate (Euro-Collins [EC]), and low (Universi
ty of Wisconsin solution [UW]) risks of reperfusion injury.
RESULTS: Baseline (in situ) PDs were similar in all groups (-37 +/- 4 mV, m
ean +/- SD). Ten minutes postresection, hepatic PDs were as follows: NS, -2
3.8 +/- 3.5 mV; EC, -11.4 +/- 0.4 mV; and UW, -8.7 +/- 0.3 mV (P <0.01 for
all groups). Maximum depolarization occurred at 6 hours postresection (NS,
-8.1 +/- 1.1 mV; EC, -7.7 +/- 1.3 mV; and UW, -8.6 +/- 1.0 mV), To determin
e whether these changes are of pathophysiologic importance, the NS solution
was modified (addition of 0.1% ethanol) to achieve similar PD changes as t
hose observed with UW. Liver transplants were then performed where the dono
r livers had been perfused and preserved for 6 hours with either NS or the
modified NS (MNS) solution. Posttransplant (10 day) survival was 1 of 6 (17
%) in the NS group and 4 of 6 (67%) in the MNS group (P <0.05), Regarding t
he effects of PD changes on ionic flux, intracellular calcium levels were d
ocumented for up to 4 hours by fluorescence video microscopy using Fura-a i
n isolated hepatocytes exposed to NS, UW, and MNS solutions. Intracellular
calcium levels were similar in all solutions at each time point studied.
CONCLUSIONS: The results of this study indicate that hepatocytes undergo pr
ompt and marked depolarization following hepatic resection, and the extent
of the depolarization correlates with survival following transplantation. A
m J Surg. 2000;179:154-160. (C) 2000 by Excerpta Medica, Inc.