Influence of perfusate on liver viability during hypothermic machine perfusion

Figure 1 Schematic diagram of hypothermic machine perfusion. In this study, single vessel (portal vein) perfusion was performed.

Figure 2 Histopathological appearance of the livers in the studies at 6 h after perfusion (hematoxylin and eosin staining, original magnification × 200). A: Saline; B: UW; C: HTK. Sinusoid lining (arrow) and congestion of the sinusoids and central vein (white arrow head).

Figure 3 Levels of aspartate aminotransferase, alanine transaminase and lactate dehydrogenase during 6 h of preservation with saline perfusates (static cold storage vs hypothermic machine perfusion: Alanine transaminase 3, 225. 00 ± 105.62 vs 49.50 ± 18.50, P = 0.047; LDH3, 1362.17 ± 563.30 vs 325.75 ± 147.43, P = 0.041). ^aStatistically significant difference. ALT3 means the ALT level at 3 h after liver preservation. AST: Aspartate aminotransferase; ALT: Alanine transaminase; LDH: Lactate dehydrogenase; SCS: Static cold storage; HMP: Hypothermic machine perfusion.

Figure 4 Levels of aspartate aminotransferase, alanine transaminase and lactate dehydrogenase during 6 h of preservation with University of Wisconsin cold-storage solution perfusates (static cold storage vs hypothermic machine perfusion: Lactate dehydrogenase 6, 2880. 14 ± 948.46 vs 2135.00 ± 174.27, P = 0.049). ^aStatistically significant difference. LDH6 means the LDH level at 6 h after liver preservation. AST: Aspartate aminotransferase; ALT: Alanine transaminase; LDH: Lactate dehydrogenase; SCS: Static cold storage; HMP: Hypothermic machine perfusion.

Figure 5 Levels of aspartate aminotransferase, alanine transaminase and lactate dehydrogenase during 6 h of preservation with histidine-tryptophan-ketoglutarate solution perfusates (static cold storage vs hypothermic machine perfusion: Aspartate aminotransferase 6, 307. 50 ± 52.95 vs 185.20 ± 20.46, P = 0.041). ^aStatistically significant difference. AST6 means the AST level at 6 h after liver preservation. AST: Aspartate aminotransferase; ALT: Alanine transaminase; LDH: Lactate dehydrogenase; SCS: Static cold storage; HMP: Hypothermic machine perfusion.

Figure 6 Levels of malondialdehyde in all groups at 6 h after perfusion. UW: University of Wisconsin cold-storage solution; HTK: Histidine-tryptophan-ketoglutarate solution.

Figure 7 Portal vein resistance among hypothermic machine perfusion subgroups. The left panel shows a classical pressure record during perfusion from each subgroup while the right panel shows the results of statistical analysis. UW: University of Wisconsin cold-storage solution; HTK: Histidine-tryptophan-ketoglutarate solution.

Figure 8 Dry/wet weight ratio (A) and adenosine-triphosphate levels (B) among hypothermic machine perfusion subgroups. D/W: Dry/wet weight ratio; UW: University of Wisconsin cold-storage solution; HTK: Histidine-tryptophan-ketoglutarate solution.