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127. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

20.04. - 23.04.2010, Berlin

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Assessment of a chloride-poor vs. a chloride-containing modified HTK solution in a rat liver transplantation model

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  • Christian Dominik Fingas - Mayo Clinic College of Medicine, GI Research, Rochester, Minnesota, USA
  • Shengli Wu - Universitätsklinikum Essen, Institut für Physiologische Chemie, Essen, Deutschland
  • Yanli Gu - Universitätsklinikum Essen, Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Essen, Deutschland
  • Jeremias Wohlschlaeger - Universitätsklinikum Essen, Institut für Pathologie und Neuropathologie, Essen, Deutschland
  • Uta Dahmen - Universitätsklinikum Essen, Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Essen, Deutschland
  • Andreas Paul - Universitätsklinikum Essen, Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Essen, Deutschland
  • Herbert de Groot - Universitätsklinikum Essen, Institut für Physiologische Chemie, Essen, Deutschland
  • Ursula Rauen - Universitätsklinikum Essen, Institut für Physiologische Chemie, Essen, Deutschland

Deutsche Gesellschaft für Chirurgie. 127. Kongress der Deutschen Gesellschaft für Chirurgie. Berlin, 20.-23.04.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. Doc10dgch345

doi: 10.3205/10dgch345, urn:nbn:de:0183-10dgch3456

Published: May 17, 2010

© 2010 Fingas et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Introduction: Recent in vitro studies on cold-induced cell injury revealed detrimental effects of extracellular chloride during cold storage of isolated rat hepatocytes while the influence of chloride on various endothelial cells was beneficial. In order to find out which of these effects predominates in vivo, we here tested a chloride-poor versus a chloride-containing variant (0.04 vs. 34.04 mM Clˉ) of a new developed HTK-based preservation solution in a rat liver transplantation model.

Materials and methods: The study, carried out in a blinded fashion with 7–8 rats/group, was divided into two parts: 1) comparison of survival in three series under different conditions (different microsurgeons, rat strains, cold [24 h/12 h/3 h] and warm [17.1±1.6 min/19.7±3.2 min/25.0±0.0 min] ischemic times), 2) assessment of microcirculation by means of intravital microscopy (video recording: 30–90 min after reperfusion), laboratory data, bile production and histology.

Results: In each of the survival experiments a (strong) tendency towards a prolonged survival rate was observed with the chloride-containing modified solution (50% vs. 12.5%; 75% vs. 37.5%; 100% vs. 71.4%). Additionally, post-reperfusion sinusoidal perfusion rates (83.9±4.0% vs. 69.2±10.8%; p<0.01) as well as blood flow velocities in sinusoids (147.7±26.7 µm/s vs. 115.5±26.0 µm/s; p<0.05) and postsinusoidal venules (332.4±87.3 µm/s vs. 205.5±53.5 µm/s; p<0.01) were clearly higher with chloride. Moreover, serum activities of liver enzymes were slightly reduced (n.s.) while bile production was significantly increased after cold storage in the chloride-containing new solution.

(Figure 1 [Fig. 1])

Conclusion: Our data suggest that beneficial effects of chloride-containing media on the endothelium/microcirculation exceed chloride-dependent hepatocyte injury. Therefore, preservation solutions for liver grafts should contain chloride.