Research Article: A new organ preservation solution for static cold storage of the liver. Amniotic fluid1

Date Published: April 29, 2019

Publisher: Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia

Author(s): Başak Büyük, Tuba Demirci, Yasemen Adalı, Hüseyin Avni Eroğlu.

http://doi.org/10.1590/s0102-865020190040000002

Abstract

To evaluate the effect of amniotic fluid in liver preservation in organ transplantation, and compare it with standard preservation solutions.

The groups consisted of Group 1: Ringer Lactate (RL) group, Group 2: HTK group, Group 3: UW group, Group 4: AF group. The livers of rats from Group 1, 2, 3, and 4 were perfused and placed into falcon tubes containing RL, HTK, UW, and AF solutions at +4‎°C, respectively. The tubes were stored for 12 hours in the refrigerator at +4°C. Tissue samples were taken at the 6th and 12th hours for histopathological examinations of the perfused livers, and storage solutions for biochemical analyzes at 6th and 12th hours.

AF was shown to maintain organ viability by reducing the number of cells undergoing apoptosis. Histopathological changes such as sinusoidal dilatation, hydropic degeneration, and focal necrosis were found to be similar to the groups in which the standard organ preservation solutions were used. Additionally, the results of INOS, IL-10, and TNF-α,which were evaluated immunohistochemically, have been shown to be similar to the UW and HTK groups.

AF provided conservation similar to UW and HTK in the 12-hour liver SCS process. The fact that apoptosis values are comparable to standard preservation solutions supports the success of AF in the cold storage of the liver.

Partial Text

Liver transplantation (LT) is a vital treatment option for patients with end-stage liver failure1,2. Despite new surgical techniques, intensive care units, and recent advances in immunosuppressive therapies, a significant problem for patients waiting for transplantation is organ shortage, and the deficit between pending patients and the number of organs obtained is increasing day by day1,3-6. Since the number of organs derived from donors is limited, many patients lose their lives while waiting for an organ7. Furthermore, postoperative transplantation failure still persists, and many patients cannot survive long enough for re-transplantation due to insufficient donors2.

This study employed an experimental design with four randomization groups. The study was approved by the Çanakkale Onsekiz Mart University (ÇOMÜ) Experimental Animal Research Ethics Committee (Approval number: 2016-02-03). Animal procedures were performed according to the “Guide for the ‎Care and Use of Laboratory Animals” principles23. All steps of the study were conducted at the experimental research center of the university, open for supervision.

The mean and standard deviations of the numerical variables are given in Table 1.

At the end of this study, the AF was shown to protect the liver throughout the 12-hour cold ischemia period in rats, comparable to standard organ preservation solutions, and maintained organ viability by reducing the number of cells undergoing apoptosis. Histopathological changes such as sinusoidal dilatation, hydropic degeneration, and focal necrosis were found to be similar to the groups in which the standard organ preservation solutions were used. Additionally, the results of INOS, IL-10, and TNF-alpha, which were evaluated immunohistochemically, have been shown to be similar to the UW and HTK groups.

Successful storage of the liver in the SCS process results in a reduction in reperfusion injury. In this study, we did not reperfuse the liver in the cold ischemia model. Therefore, I/R damage assessment and post-transplant success could not be detected. Some intracellular mechanisms in the transplantation process contribute to cell damage. ATP depletion during ischemia causes loss of the transcellular electrolyte gradient, activation of free calcium influx and subsequent activation of phospholipases. Cell swelling and lysis occur as a result of all these events5. After ischemia-reperfusion, toxic molecules are produced primarily in the form of reactive oxygen species (ROS), leading to I/R damage5,30. In our study, besides the lack of, we also did not study the oxidative stress markers. Hence, we are unable to assess the toxic effects of ROS, which is another limitation of our study.

Amniotic fluid provided conservation similar to UW and HTK in the 12-hour liver SCS process. The fact that apoptosis values are comparable to standard preservation solutions supports the success of AF in the cold storage of the liver.

 

Source:

http://doi.org/10.1590/s0102-865020190040000002

 

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