Initial Perfusion Solution for Donor hepatectomy in Canine Liver Transplantation: Ringers' Lactated Solution: UW Solution

ABSTRACT

The purposes of initial preservation solution are rapid cooling of the organ and washing out the intravascular components. After the introduction of University of Wisconsin (UW) solution, it has become the standard organ preservation solution in liver transplantation. However, due to several problems such as high viscosity and potassium concentration, let alone its cost, there has been several attempts to use UW solution in combination with other preservation solutions for initial perfusion of the graft during the organ harvest procedure. In order to evaluate the efficacy of Ringers' Lactated (RL) solution as an initial perfusion solution, we performed orthotopic hepatic allografts on dogs. In 4 dogs, UW solution was used as the initial perfusion solution and in the other 4, RL solution was used. After initial perfusion, UW solution was used successively for the preservation of the graft. All harvested grafts were stored in UW solution. Average cold ischemic time was 163.5 minutes for RL group and 159 minutes for UW group. The two groups were compared in terms of hematologic and biochemical markers before and after the transplantation. The extent of graft injury during cold ischemia and after reperfusion was also compared directly under light and electron microscope. There was no difference in cold and warm ischemic time, anhepatic time, and total operation time between the two groups. The groups did not differ in liver function test, complete blood count and coagulation profile. Histologic exams also showed similar changes between the two groups. In conclusion, RL solution can be used as the initial perfusion solution in hepatic transplantation.