Significance of Donor Nutritional Status for Rewarming Injury of the Hepatic Graft in Rats

Abstract

We studied the significance of donor nutritional status for hepatic rewarming injury and the usefulness of the glucagon loading test for the assessment of donor nutritional status in rats. In experiment 1 the animals were either free fed or fasted for 6, 24 or 48 h. The livers were preserved in chilled lactated Ringer’s solution for 4 h and were divided into eight groups according to the fasting and rewarming periods. The ammonia level in the graft effluent was increased in grafts preserved for 24 h or longer, which was augmented when rewarming time was increased from 15 to 30 min (p < 0.05). In experiment 2, the animals were divided into four groups (n = 3 each) according to the fasting period. The hepatic tissue glycogen content was measured after fasting, and the serum glucose was measured after the administration of 50 µg/kg of glucagon i.v. The hepatic tissue glycogen content correlated with the increase rate of serum glucose (p = 0.0001). We conclude that glycogen may protect the hepatic graft from rewarming injury by improving energy status, particularly in prolonged rewarming. The glucagon loading test seems to be useful for assessing the glycogen content of the hepatic graft.

The Physiology of Brain Death and Organ Donor Management

“…A signifi cant improvement in hepatic sinusoidal lining cell viability has been demonstrated in rats with liver grafts from donors receiving enteral feeding and intraperitoneal glucose prior to liver procurement. Glycogen appears to protect the hepatic graft upon rewarming in rats [ 111 ].…”