Título

Highlights of protection mechanisms involved in liver graft cold ischemia preservation: An IGL-1 and HTK appraisal

Introdução

IGL-1 is usually used in clinical transplantation as alternative to UW and HTK solutions, as indicated by European Register of Liver Transplantation (ELTR). Comparative appraisals between IGL-1
UW solutions have been carried out but no studies are reported comparing IGL-1 (PEG 35 as oncotic agent) vs HTK ( with no oncotic agent). In this communication, we evaluate the cold ischemia injury and the differential preservation mechanisms fatty liver grafts are in IGL-1 and HTK solutions for 24º C. at º4C, respectively.

Material e Método

Male Zucker Obese rats aged 10 weeks were classified as follows: Group 1( IGL1) = liver grafts washed with 50 mL of IGL-1 and preserved 24h at 4º with IGL-1. Group 2 (HTK) = Same as Group 1 but using 125 mL of HTK and preserved 24h at 4ºC. Group3 Controls: liver grafts were flushed with RLS after laparotomy without cold storage. We determined AST/ALT, GLDH, e-NOs activity (p-eNOS), endoplasmic reticulum stress (ERS) (GRP78, PERK) and apoptosis, respectively

Resultados

AST and ALT levels showed a better protection of fatty liver grafts preserved in IGL-1 when compared to HTK. This was consistent with a better mitochondrial protection which was accompanied by enhanced increases in AMPK and e-NOS expression of preserved liver grafts in IGL-1 vs HTK. Endoplasmic reticulum stress (ERS) changes and apoptosis were also prevented.

Discussão e Conclusões

The presence of PEG3 (in IGL-1) vs no oncotic agent in HTK, seems determinant for the activation of e-NOS and cyto-protective factors as adenosine monophosphate protein kinase (AMPK) and the prevention of ER stress, respectively during cold ischemia storage. This justifies the better protection induced by IGL_1 solution after 24h-of cold ischemia when compared to HTK

Palavras Chave

HTK, IGL-1, cold ischemic injury, fatty liver preservation