Better recovery of livers from non-heart beating donors after preservation by machine perfusion at 20°C than cold storage.

Background and aim: We previously reported that machine perfusion (MP) performed at 20°C greatly enhanced the preservation of steatotic rat livers. Here, we tested whether rat livers retrieved 30 min after cardiac arrest (NHBDs) were better protected by MP at 20°C than by MP at 4°C or cold storage. We also compared the recovery of livers from NHBDs with organs obtained from heart beating donors (HBDs) preserved by cold storage. Materials and methods: MP technique: livers were perfused for 6 hours with UW-G modified at 20°C or 4°C. Cold storage: livers were flushed in situ and preserved with UW solution at 4°C for 6hrs. Both MP and cold storage preserved livers were reperfused with Krebs-Heinselet buffer (2hrs at 37°C). AST and LDH release and mitochondrial glutamate dehydrogenase (GDH) levels were evaluated. Parameters assessed included: bile production and biliary enzymes; tissue ATP; reduced and oxidized glutathione (GSH/GSSG); protein–SH group concentration. Results: Livers preserved by MP at 20°C showed significantly lower hepatic damage at the end of reperfusion compared with MP at 4°C and cold storage. GDH release was significantly reduced and bile production, ATP levels, GSH/GSSG and protein–SH groups were higher in livers preserved by MP at 20°C than with MP at 4°C and cold storage. The best preserved morphology and high glycogen content was obtained with livers submitted to MP at 20°C. Liver recovery using MP at 20°C was comparable to recovery observed with HBDs. Conclusions: MP at 20°C improves cell survival and gives a better-quality of preservation for livers obtained from NHBDs and may provide a new method for the successful utilization of marginal livers