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RESEARCH PRODUCT

Hypothermic Oscillating Liver Perfusion Stimulates ATP Synthesis prior to Transplantation

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Abstract Background. ATP and glycogen depletion often have been demonstrated during cold storage of the liver prior to transplantation. Suppression of events that lead to metabolic depression and to lipid peroxidation could contribute to improvement of liver preservation. A new method of liver preservation for transplantation is therefore suggested, an oscillating oxygenated hypothermic liver perfusion. Methods. Biochemical analysis of liver tissue samples and perfusate after 10 h of perfusion by the presented oscillating perfusion model were compared with results after continuous liver perfusion for 10 h as well as with data derived from cold-stored livers over a period of 10 h. Particular reference was made to nucleotide metabolites, glycogen content, lipid peroxidation, glutathione content, glycolytic metabolites, and enzyme release before and after preservation. Results. Glycogen depletion occurred to the same degree in hypothermic storage and machine perfusion (oscillating as well as continuous perfusion), but the energy charge was significantly increased after oxygenated perfusion, whereas cold storage resulted in a significant energy charge depletion. In addition, perfusion by an oscillating technique yielded superior energy charge loading compared to the continuous perfusion technique and diminished the other hand lipid peroxidation. Conclusions. Hypothermic oscillating oxygenated perfusion could be important for the improvement of the quality of energy-depleted organs prior to transplantation.