A Simple Method for Short-Term Preservation of a Liver Homograft1

Liver transplantation in man after an extended period of preservation by a simple technique.

“…Recent reports have suggested that good liver function may still be obtained when the organ is removed after cessation of heart beat, provided it is cooled by infusion beginning within 15 minutes of death (Calne and Williams, 1968 ;Schalm, 1968). This report confirms the value of simple cooling by infusion and indicates, moreover, that satisfactory function may still be obtained after preservation for as long as five hours.…”

“…Whereas expermental evaluation of this technique in the dog provided only three and a half hours of safe ischaemia (Schalm, 1968), this interval may apparently be extended in man.…”

Liver Transplantation in Man--I, Observations on Technique and Organization in Five Cases

“…The irreversible ischaemic damage in Case 1 leading to an uncontrollable haemorrhagic syndrome reinforces the importance of reducing the warm ischaemic time to a minimum of 15 minutes between death of the donor and cooling of the liver. In the subsequent four cases the donor liver was cooled within 15 minutes of death, and in Cases 3-5, with total ischaemic times (from death of donor until revascularization with portal blood) of 141, 106, and 94 minutes, excellent preservation was achieved by the simple cooling that was used (Schalm, 1968).…”

“…of heparin and then with 500 ml. of plasma/bicarbonate/glucose solution' (Schalm, 1968). An incision was made into the inferior vena cava to allow the perfusate to escape.…”

“…If this is followed by a cold plasma/bicarbonate/dextrose solution the liver can be kept at 4°C. with little deterioration for two hours (Schalm, 1968). Slow deterioration does, however, occur, and, since hepatectomy of the recipient can be an extremely difficult and time-consuming operation, longer preservation is desirable.…”