The influence of fasting on preserved liver and transplantation outcome : an animal experiment / 한국간담췌외과학회지

ABSTRACT

During liver transplantation, as a rule, liver can be preserved for 24 hr or more. Livers can be successfully preserved with simple cold storage, but some transplanted livers may have poor or no(primary nonfunction) function. Several factors have been investigated to aid in the production of primary nonfunction. No single parameters has been established absolutely governing the acceptance of a donor for organ harvest. The quality of the liver may dependent upon many factors, such as the time of preservation and the condition of the donor may contribute, too. In this study, we have investigated the effects of fasting on the quality of liver preservation by simple cold storage. Mixed breed pigs(30-40kg) were fasted for 72hr, livers preserved for 12hr, and viability determined by orthotopic transplantation. The liver function(AST, LDH) was examined 1 hr, 6 hr, 24 hr after transplantation. Livers from fasted animals were less viable than livers from fed animals. Pigs receiving livers from fed animals preserved for 12 hr had better survived than livers from fasted animals. The results show that the nutritional status of the donor can affect the outcome of liver preservation and transplantation. Increased injury in livers from fasted animals may be due to the loss of glycogen that may be an essential source of energy in the initial posttransplantation period. In clinical setting, donor's nutritional status may be an important factor in the initial function of the transplanted liver, and methods to increase donor's nutritional status may be important in increasing the quality of liver.