Canine and human liver preservation for 6 to 18 hr by cold infusion

Abstract

Forty-one dog livers were preserved with cold, lactated Ringer's, plasma, or intracellular (Collins) solutions. Consistent survival was obtained with all three solutions for 9 hr. After 18 hr, the plasma and Collins solutions permitted survival, with the Collins solution having a slight overall advantage. The method using Collins solution has been used to preserve seven human livers in Los Angeles, to transport the organs to Denver, and to transport them as orthotopic grafts from 6 hr, 45 min to 10 hr later.

Figure 1

The effect of preservation for 9 hr upon orthotopic liver grafts in dogs. In the control experiments, transplantation was carried out immediately after flushing with cold, lactated Ringer’s solution and after preservation for 1 hr or less. Although immunosuppression was not used, one animal in group C₁ (arrow) is still alive after 80 days.

Figure 2

The effect of preservation for 18 hr upon orthotopic liver grafts in dogs. The experimental and control conditions were the same as for Figure 1.

Figure 3

The course of a 7-year-old child who received a liver that was removed in Los Angeles, preserved for 7½ hr, flown 1,000 miles to Denver by a commercial airliner, and transplanted. Initial function was excellent. A biopsy taken 2 ½ weeks later, when horaograft function deteriorated, was interpreted as hepatitis. The recipient is well 6 months postoperatively.