Protective Effect To The Transplanted Liver By Continuous Hypothermic Perfusion To Liver Donor During Keeping Time

BackgroundSince the frist orthotopic liver transplantation was successfully operated by Starzl in 1963,liver transplantation has become one of the effective methods to cure the final liver disease.With the scarce of the liver donor,the methods for the storage of liver donor are called for more researched.Nowdays,the pervasive method is the traditional way,that is static cold storage.Another method can be acquired in the nearest reference,that is continuous hypothermic reperfusion storage,howerer no evidence can be found that this method has effect to the transplanted liver.So we have made this study to explore the protective effect to the transplanted liver by continuous hypothermic perfusion to the liver donor during the keeping time.ObjectiveTo explore the protective effect to the transplanted liver by continuous hypothermic perfusion to the liver donor during the keeping time.MethodsThe rats liver doners has been storaged in different methods(continuous hypothermic reperfusion storage and static cold storage)for 5 hours.Then orthotopic liver transplantation model was established according to Kamada's method.Sixty Wistar rats were randomly divided into three groups.1.Sham group,duodenohepatic ligament was dissected only,without inflow occlusion;2.C group:Continuous hypothermic reperfusion group2.1 The rats as donors,12 rats.The liver donors were storaged in the method of continuous hypothermic reperfusion for 5 hours.2.2 The rats as accepters,12 rats.Orthotopic liver transplantation model was established.3.R group:Static cold storage group.3.1 The rats as donors,12 rats.The liver donors were storaged in the method of static cold storage for 5 hours.3.2 The rats as accepters,12 rats.Orthotopic liver transplantation model was established.Blood samples and hepatic tissue samples were taken from every group after 24 hours of transplantation and the bile flow was taken for 24 hours,which were used to analyze the serum transaminase levels,biliary glucose and GGT levels, histopathologic examination,the levels of average bile flow.The apoptotic cells were detected by flow cytometry.In each model,the indexes were compared.Results1.In both models,the levels of AST and ALT in R group and C group were higher than in Sham group(P＜0.05),and the levels of AST and ALT in C group were lower than in R group(P＜0.05).2.In both models,the lever of average bile flow in C group was higher in R group(P＜0.05).3.In both models,biliary glucose and GGT levels in R group and C group were significant higher than in Sham group(P＜0.01),and the levels of biliary glucose and GGT in C group were lower than in R group(P＜0.05).4.In both models,the apoptotic index(AI)in R group and C group were higher than in Sham group(P＜0.05),and the AI in C group were lower than in R group(P＜0.05).5.In both models,the damage of hepatic histology in R group were serious.And the damage was less in C group.Conclusions 1.Continuous hypothermic perfusion storage method of liver donor during the keeping time has protective effect to the liver after transplantation.2.Continuous hypothermic perfusion storage method of liver donor during the keeping time can inhibit the infiltration of heterophil granulocyte;inducing the cell apoptosis of the liver after transplantation.