Real-time Assessment Of Liver Quality In Cold Ischemia Injury Based On Lscm Technique

Background&Aims:Liver transplantation(LT)is only viable treatment option for end-stage liver diseases and acute liver failure.Increasing organ scarcity had motivated parts of transplant centers to extended donor criteria(EDC).Along with the EDC had been widely adopted around the world,the early allograft dysfunction(EAD)incidence has increased to 23.7%.Actually,in EDC allografts,EAD is mainly correlate with the long-time of cold-ischemia.How to make effective and exact assessments of injuries which were caused by long-time of coldischemia is more and more important.So,in this study,we will apply laser scanning confocal microscope(LSCM)and parts of clinical liver function examine items to assess quality of donor liver allografts.Methods: Total 20 Rats were used to make cold-ischemia models of liver allografts.According to different time of cold-ischemia,we set 4 groups: CIT1h、CIT6h、CIT12h and CIT24 h.At the end of CIT time of each group,we collect the perfusion and preservation fluids and then we perfuse fluoresceins.After that we take LSCM examinations,meanwhile,parts of tissues were harvested and were taken HE examination.At last,we make a comparison between LSCM results and HE results.Results: Along with the time extending,the quality of liver allograft is keep decreasing.In CIT1 h and CIT6 h,Both of LSCM and HE can have a good view of liver micro-structures and those structures are all detailed and tight.In CIT12 h,LSCM can’t have a well view of liver microstructures and also hepatic nucleus can’t be well stained.HE results are consistent with LSCM results.HE results shows us that liver microstructures can’t be distinguished and also hepatic nucleus can’t be well stained.The detections of clinical items in preservation and reperfusion fluid of donor liver allografts show us that the levels of ALT、AST and LDH are keep increasing along with the extend of cold-ischemia time.However,take all the 3 items into consideration,we can find that only LDH have significant difference(***,P<0.001).Conclusion: LSCM can be well used in the evaluation of the liver allografts qualities in ex vivo.Easy control and save time can be great advantages of LSCM.In a separate liver organ,compared with ALT and AST,LDH can be a much more critical indicator when reflect the quality of liver allografts.Meanwhile,take the LDH into consideration can make our assessment much more comprehensive.