The Effects of Short-Term Subnormothermic Perfusion after Cold Preservation on Liver Grafts from Donors after Cardiac Death: An Ex Vivo Rat Model

AbstractBackgroundWe previously reported that short oxygenated warm perfusion before cold storage (CS) had improved the graft viability of rat livers from donors after cardiac death (DCD). In this study, we investigated the effectiveness of short-term oxygenated subnormothermic perfusion for different durations after CS in a rat DCD model.MethodsWe used an isolated perfused rat liver system. In Study 1: the grafts were retrieved from Wistar rats 30min after cardiac arrest (thoracotomy), preserved in CS for 6h, and perfused with oxygenated subnormothermic (20-25°C) Krebs-Henseleit buffer for different durations (0, 15, 30, 60, and 90min groups; n=5 in each). In Study 2: in addition to subnormothermic ex vivo liver perfusion (SELP), after 15min incubation at room temperature, the grafts were reperfused under normothermic condition for 60min as a model of liver transplantation (0, 30, 60, and 90min groups; n=5 in each).ResultsIn Study 1, portal flow, bile production and tissue adenosine triphosphate (ATP) increased with perfusion duration. In Study 2, SELP significantly improved portal flow volume (P

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