Modification Of The Perfusate For Standard Donor In Liver Transplantation

BackgroundLiver transplantation is an effective treatment for end-stage liver disease, with usually excellent outcomes, but still has challenges.Donor shortage is a major problem. Therefore, the way to expand the scope of donor supplyment, how to rational use of marginal donor and improve the donor quality become an emergency. Many experiments have proved that donor quality can effectively improved after machine perfusion, with improving donation rats and outcomes. Nowadays, it’s urgent to find a solution that can both increase the time of donor preservation and reduce the oxygen free radicals and inflammatory mediators. In this experiment, the effects of a novel perfusate on the protection of donor liver were studied by using the histidine-tryptophan-ketoglutarate solution (HTK) with green tea polyphenol(GTP) and dissolved oxygen though machine perfusion.MethodModified perfusate of GTP+HTK:Sprague-Dawley Rats were randomized into groups as follows:(1) HTK control group(n=6 per group);(2)HTK+GTP(60μg/ml)(n=6 per group).Modified perfusate of 02+HTK:(1)HTK control group(n=6per group);(2)The HTK medium was continuously gassed with 95% 02 and 5% CO2 gas mixture (n=6 per group).We removed livers from rats with portal vein and bile duct catheterization. Then we connected portal catheter and machine perfusion system. Afterwards we started to perfuse using the flow rate of 5 rpm. The perfusate was collected at seven time points (Oh, 1h,3h,6h,8h, 10h,12h) for measurement of liver function (aminotransferase(AST), alanine transaminase(ALT),lactate dehydrogenase(LDH)) and electrolytic(Na,K,C1) Meanwhile we preserved a part of liver tissue fixed in 10% neutral formalin for later histological study (histopathologic, immunohistochemical,).The fresh liver tissue samples were collected and stored in-80 ℃ for further analysis (malondialdehyde (MDA), myeloperoxidase(MPO)ResultBetween HTK group and GTP group, higher ALT (8h,10h:p<0.05; 12h:p<0.01), AST(10h:p<0.05;12h:p<0.01),LDH (1h,3h,6h,8h,10h,12h:p<0.05) MPO(p<0.05),MDA (p<0.01) were found in HTK control group. Speak of pathological part, HTK control group was obviously infiltrated with inflammatory cells, congestion of sinusoids and central vein was serious. Between HTK group and HTK+O2 group, higherALT (6h,8h,10h:p<0.05),AST(8h,10h,12h:p<0.05),LDH(6h,8h,10h:p<0.05)MPO(p<0.05),M DA (p<0.05) were found in HTK control group. Speak of pathological part, HTK control group was obviously infiltrated with inflammatory cells, congestion of sinusoids and central vein was serious.ConclusionGreen tea polyphenol and dissolved oxygen have a protective effect on donor liver in rat liver transplantation though hypothermic machine perfusion (HMP).