| Popis: |
Livers cold preserved during variable periods of ischemia suffer functional, morphological and hemodynamic alteration, which are exacerbated when they are reperfused. One important injury is glycogen depletion during cold ischemia/ reperfusion. How liver can restore their energy during reperfusion is related with the preservation time, nutritional status of the donor, and the preservation solution used. However, there are some treatments that help livers to preserve their energy storage. These procedures used drugs or metabolites, which are added to the liver to maintain their glycogen storage during preservation, time and allow the organ to restore its energy during reperfusion. There are several publications where the nutritional status of the donor was studied. There is controversy about the quality or the donor organ. Some authors say that fasted animals are better donors because this condition reduced hepatic injuries; others think that fed animals provide the necessary glycogen (energy) to improve liver preservation, reducing morphological and functional damages. Many others are convinced that nutritional status of the donor is not relevant because hepatic injuries will occurred even though the donor was fed or not. The preservation solution has an important role in reducing liver damages during cold ischemia/reperfusion and in restoring liver energy storage. Storage in HLR (histidine, lactobionate and raffinose) solution facilitated the resuscitation of energetic status and preserved adenine nucleotide levels significantly greater than Marshall’s citrate or Bretschneider’s histidine-based solution (HTK). University of Wisconsin (UW) proved to be suitable for energy recovery during reperfusion. In conclusion, the aim of this review is to present studies performed by different authors where they analyzed preservation/reperfusion injuries, how the liver restores its energy storage during reperfusion time, different strategies to avoid glycogen depletion during cold ischemia/reperfusion, the efficacy of preservation solutions and the effect of nutritional status of the donor to prevent functional alteration of the liver during cold preservation. |
