Ischemic Preconditioning of Rat Livers from Non-Heart-Beating Donors Decreases Parenchymal Cell Killing and Increases Graft Survival after Transplantation

Abstract EN

A critical shortage of donors exists for liver transplantation, which non-heart-beating cadaver donors could help ease.

This study evaluated ischemic preconditioning to improve graft viability after non-heart-beating liver donation in rats.

Ischemic preconditioning was performed by clamping the portal vein and hepatic artery for 10 min followed by unclamping for 5 min.

Subsequently, the aorta was cross-clamped for up to 120 min.

After 2 h of storage, livers were either transplanted or perfused with warm buffer containing trypan blue.

Aortic clamping for 60 and 120 min prior to liver harvest markedly decreased 30-day graft survival from 100% without aortic clamping to 50% and 0%, respectively, which ischemic preconditioning restored to 100 and 50%.

After 60 min of aortic clamping, loss of viability of parenchymal and nonparenchymal cells was 22.6 and 5.6%, respectively, which preconditioning decreased to 3.0 and 1.5%.

Cold storage after aortic clamping further increased parenchymal and non-parenchymal cell killing to 40.4 and 10.1%, respectively, which ischemic preconditioning decreased to 12.4 and 1.8%.

In conclusion, ischemic preconditioning markedly decreased cell killing after subsequent sustained warm ischemia.

Most importantly, ischemic preconditioning restored 100% graft survival of livers harvested from non-heart-beating donors after 60 min of aortic clamping.