Ar'Rajab A, Ahrén B, Sundberg R, Bengmark S
Department of Surgery, Lund University, Sweden.
Transplantation. 1992 Apr;53(4):742-5. doi: 10.1097/00007890-199204000-00006.
UW solution is at present the most efficient solution for preservation of livers for transplantation. We have developed an alternative solution based on dextran instead of hydroxyethyl starch and without raffinose, allopurinol, magnesium sulfate, insulin, penicillin, or dexamethasone, which all are used in UW solution. In addition, 62.5 mM potassium in UW solution is replaced with sodium. We tested this new solution for liver preservation using the isolated perfused rabbit liver. We found that livers preserved in the UW solution for 24 or 48 hr lost 11.6 +/- 2.6% and 16.8 +/- 2.0% of the prepreservation weight, respectively, as a sign of organ shrinkage (P less than 0.001). In contrast, no change in liver weight was observed after preservation in the new dextran-based solution. Similarly, no change in total tissue water of the rat liver slices was seen after preservation in the new solution. Furthermore, livers preserved for 24 hr in the UW solution or the new solution produced the same amount of bile as unpreserved livers. However, after preservation in the UW solution for 48 hr, bile production was reduced by 65% (P less than 0.05). In contrast, livers preserved for 48 hr in the new solution showed no reduction in bile production. We conclude that our new solution significantly improves long-term liver preservation, and with this modified solution, 48-hr preservation may be safe.
UW液目前是用于肝脏移植保存的最有效溶液。我们研发了一种替代溶液，该溶液以右旋糖酐为基础，而非羟乙基淀粉，且不含UW液中所使用的棉子糖、别嘌呤醇、硫酸镁、胰岛素、青霉素或地塞米松。此外，UW液中62.5 mM的钾被钠取代。我们使用离体灌注兔肝对这种新溶液进行肝脏保存测试。我们发现，在UW液中保存24小时或48小时的肝脏，分别损失了保存前重量的11.6±2.6%和16.8±2.0%，这是器官萎缩的迹象（P<0.001）。相比之下，在新的基于右旋糖酐的溶液中保存后，肝脏重量未观察到变化。同样，在新溶液中保存后，大鼠肝切片的总组织水也未见变化。此外，在UW液或新溶液中保存24小时的肝脏产生的胆汁量与未保存的肝脏相同。然而，在UW液中保存48小时后，胆汁分泌减少了65%（P<0.05）。相比之下，在新溶液中保存48小时的肝脏胆汁分泌未见减少。我们得出结论，我们的新溶液显著改善了肝脏的长期保存，使用这种改良溶液，48小时的保存可能是安全的。
