[Preparing the donor with glycine improves survival after liver transplantation in the animal model]

Abstract

The etiology of primary graft non-function has been linked to storage and reperfusion injury. Recently, graft manipulation during harvest was shown to aggravate reperfusion injury in livers effecting outcome after transplantation detrimentally. Since Kupffer cells play a pivotal role in reperfusion injury, glycine (1 ml, 300 mM) was infused into donors for one hour before harvest to prevent Kupffer cell activation. Valine was used as isonitrogenous control. To assess the influence of gentle manipulation, livers from female Lewis rats were dissected for 12 minutes minimally and harvested within 25 minutes. During the last 13 minutes, the organ was gently manipulated or left alone in the controls. Minimal dissection during harvest without manipulation had no influence on survival after liver transplantation (100%); however, gentle manipulation for 13 minutes decreased survival to less than 50%. Further, transaminases were elevated seven-fold after transplantation by manipulation. Glycine infusion totally prevented the effects of organ manipulation on survival and enzyme release. These data indicate for the first time that pretreatment of donors with intravenous glycine prevents the detrimental effects of graft manipulation during harvest on outcome.