Improved Preservation and Microcirculation with POLYSOL After Partial Liver Transplantation in Rats

Background. Due to the severe shortage of deceased donors, demand for living-donor liver transplantation (LDLT) has increased worldwide. Here, we compared POLYSOL, a recently developed low-viscosity preservation solution, and histidine-tryptophan-ketoglutarate (HTK) for cold storage of partial liver graft in this study. Methods. Partial liver transplantations with 30% of the native liver were performed in Lewis rats. The graft livers were flushed with either HTK or POLYSOL (n = 25, respectively) and stored in the respective solution for 3 h at 5 degrees C. Graft function was evaluated regarding ischemia-reperfusion injury and regeneration at 1, 3, 24, and 168 h after reperfusion. Results. POLYSOL preservation resulted in improvement of portal venous flow (HTK versus POLYSOL; mean +/- SEM: 16.8 +/- 2.2 versus 21.6 +/- 2.1 mL/min; P = 0.005), microcirculation (383 +/- 63 versus 532 +/- 64 Flux; P = 0.045), ALT (310.2 +/- 56.1 versus 181.8 +/- 17.0 IU/L; P = 0.0262), LDH (4052.4 +/- 764.4 versus 2494.1 +/- 410.0 IU/L; P = 0.0215), total bilirubin (21.6 +/- 14.2 versus 4.0 +/- 0.6 IU/L; P = 0.0236), malondialdehyde (100.0 +/- 4.3 versus 69.2 +/- 4.0 nmol/mL; P = 0.0015), as well histologic findings at 24 h. Liver regeneration was improved in POLYSOL with regards to liver weight (4.0 +/- 0.2 versus 4.3 +/- 0.3 g; P = 0.038) and Ki-67 labeling index (9.67 +/- 2.17 versus 1.10 +/- 0.14%; P < 0.0001) at 24 h with higher up-regulation of portal VEGF (31.55 +/- 5.78 versus 91.94 +/- 9.27 pg/mL; P = 0.0052). Conclusions. This study showed that POLYSOL improves microcirculation and thus improves the preservation quality of partial liver transplantation. (C) 2011 Elsevier Inc. All rights reserved.