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The Scientific World Journal
Volume 2012, Article ID 573410, 9 pages
http://dx.doi.org/10.1100/2012/573410
Research Article

An Innovative Hyperbaric Hypothermic Machine Perfusion Protects the Liver from Experimental Preservation Injury

1Department of Clinical Medicine, Alma Mater Studiorum University of Bologna, 40138 Bologna, Italy
2Center for Applied Biomedical Research (C.R.B.A.), Alma Mater Studiorum University of Bologna, 40138 Bologna, Italy
3Department of Experimental Pathology, Alma Mater Studiorum University of Bologna, 40126 Bologna, Italy
4Department of Internal and Public Medicine, University of Bari, 70126 Bari, Italy
5Department of Biochemistry, Alma Mater Studiorum University of Bologna, 40126 Bologna, Italy
6Centro Iperbarico s.r.l. Ravenna, 48124 Ravenna, Italy

Received 1 November 2011; Accepted 18 December 2011

Academic Editors: P. Muiesan and Y. Takada

Copyright © 2012 Ferdinando A. Giannone et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose. Hypothermic machine perfusion systems seem more effective than the current static storage to prevent cold ischemic liver injury. Thus, we test an innovative hyperbaric hypothermic machine perfusion (HHMP), which combines hyperbaric oxygenation of the preservation solution and continuous perfusion of the graft. Methods. Rat livers were preserved with Celsior solution according to 4 different modalities: normobaric static preservation; hyperbaric static preservation at 2 atmosphere absolute (ATA); normobaric dynamic preservation, with continuous perfusion; hyperbaric dynamic preservation, with continuous perfusion at 2 ATA. After 24 h cold preservation, we assessed different parameters. Results. Compared to baseline, livers preserved with the current static storage showed severe ultrastructural damage, glycogen depletion and an increased oxidative stress. Normobaric perfused livers showed improved hepatocyte ultrastructure and ameliorated glycogen stores, but they still suffered a significant oxidative damage. The addition of hyperbaric oxygen produces an extra benefit by improving oxidative injury and by inducing endothelial NO synthase (eNOS) gene expression. Conclusions. Preservation by means of the present innovative HHMP reduced the liver injury occurring after the current static cold storage by lowering glycogen depletion and oxidative damage. Interestingly, only the use of hyperbaric oxygen was associated to a blunted oxidative stress and an increased eNOS gene expression.