EVALUATION OF PRESERVATION DAMAGE AFTER PORCINE LIVER TRANSPLANTATION BY ASSESSMENT OF HEPATIC MICROCIRCULATION

Abstract
The ischemic damage following liver transplantation (LTX) is predominantly located at the endothelial cell level and is a major cause for a disturbance of microcir-culation. The present study was designed to test the hypothesis that changes in the quality of organ preservation are correlated with changes in microcirculation: 16 pigs underwent LTX, preservation by Bretschneider's HTK-solution (Histidin, Tryptophan, α-Ketoglutarat) complemented by indomethacin (50 μmol/L). Cold ischemia times were 9 hr (n=8) and 18 hr (n=8), respectively. Using the H2-clearance technique, hepatic micro-circulation was measured before, 30 min, and 20 hr after LTX. Normal tissue perfusion was 107±16 ml/100 g/min, at 30 min posttransplantation 91±13 ml/100 g/min in the short-term and 48±7 ml/100 g/min in the long-term preservation group. Whereas no animal of the long-term preservation group survived longer than 8 hr, all animals of the short-term preservation group survived, and tissue perfusion could be measured 20 hr postoperatively (101±19 ml/100 g/min). At 30 min postoperatively, all surviving animals had tissue perfusion rates grater than 70, and all nonsurvivors had values below 60 ml/100 g/min. We conclude therefore that the extent of decrease of microcirculation after LTX may be a useful predictor of organ function and survival.

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