Experimental Studies on Relationship Between Donor Starvation and Graft Viability after Liver Transplantation

Koichi Sato, Hiroshi Nozaki, Noburu Sakakibara

First Department of Surgery, Juntendo University School of Medicine

Graft viability after liver transplantation was studied from the aspects of donor fasting period and cold ischemic time (CIT) of liver preservation. Bile output during 3 hours after liver transplantation decreased according to the prolongation of CIT when the fasting period was more than 48 hours. Survival rates up to 30 days were extremely poor: 0% with 48 hours of starvation and 6 hours of CIT, and 72 hours of starvation with both 1 and 6 hours of CIT. However, less than 6 hours of cold preservation in Euro-collins solution seemed to be safe. Liver tissue ATP was significantly lower with 72 hours of starvation, and ADP and adenylate energy charge were also lower with both 48 and 72 hours of starvation. Moreover, these concentrations gradually decreased as CIT was prologned. Electron micrographic findings showed vacuoles in the parenchymal cells and blebs in the sinusoid with more than 48 hours of starvation. Sinusoidal endothelial cells were degenerated and detached with 6 hours of CIT. In conclusion, it was suggested that 48 hours of starvation and 6 hours of CIT, and 72 hours of starvation and more than I hour of CIT decreased graft viability after liver transplantation, and could be associated with poor posttransplant results.

Key words
orthotopic liver transplantation, donor starvation, cold ischemic time, primary graft nonfunction

Reprint requests
Koichi Sato First Department of Surgery, Juntendo University School of Medicine
2-1-1 Hongo, Bunkyo-ku, Tokyo, 113 JAPAN

Accepted
September 8, 1993

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