Donor liver preservation and stimulation of adhesion molecules : cold preservation initiates the cascade.

BACKGROUND: Pro-inflammatory adhesion molecules (including ICAM-1, E-Selectin) are important in clinical hepatic ischaemia and reperfusion injury. The initiating factors remain to be fully elucidated. METHODS: Needle biopsies taken during and after donor liver preservation were studied in 28 cases by immunohistochemical methods. Human responder cell cultures were exposed to the effluent cold storage solution after liver preservation in a further 10 transplants. RESULTS: Increased ICAM-1 staining was seen at the end of cold storage compared to baseline (P less than 0.01), whilst reperfusion caused further increase (P less than 0.001). The storage solutions stimulated ICAM-1 and E-Selectin expression in responder cells in vitro as a bioassay (P less than 0.01 in each case). CONCLUSIONS: Liver harvesting and cold storage can initiate adhesion molecule expression even before reperfusion in the recipient.