Nonparenchymal cell and hepatocellular injury to human liver grafls assessed by enzyme-release into the perfusate

Experimental studies have demonstrated preferential injury to the sinusoidal endothelium during liver preservation with University of Wisconsin (UW) or Euro-Collins solution. This endothelial cell injury has an unclear pathogenesis, and it has not yet been studied in the human liver. Therefore, we analyzed the effluent of 21 human liver allografts after cold storage. Markers of hepatocellular and nonparenchymal cell injury were assessed. After preservation with UW solution, early effluent samples contained 1823 ± 1494 U/1 lactate dehydrogenase (LDH), 493±516 U/1 alanine aminotransferase (ALT) and 132±97 U/1 creatine kinase (CK; 92±92 U/1 CK-BB). The effluent of livers preserved in histidine-tryptophan-ketoglutarate (HTK) solution contained 3681±2009 U/1 LDH, 1139±599 U/1 ALT and 282±120 U/1 CK (165±91 U/1 CK-BB). Comparison of effluent enzyme activities with liver tissue enzyme activities indicates that the release of the endothelial cell/nonparenchymal cell marker creatine kinase was higher, by a factor of 7–8, than the release of hepatocellular enzymes. Effluent thrombomodulin concentrations were 123±248 ng/ml (UW) and 604±299 ng/ml (HTK), and effluent glucose concentrations, 40.3± 27.0 mM (726±486 mg/dl; UW) and 10.4±4.5 mM (187 ±81 mg/dl; HTK). We conclude that prominent endothelial cell injury also occurs in human liver grafts after preservation with UW solution or HTK solution. This endothelial cell injury is unlikely to be caused by hypoxia-induced energy deficiency, as it affects a cell type with a high glycolytic capacity in the presence of high glucose levels. Determination of enzyme activities in the easily obtained effluent of liver grafts might constitute an additional parameter for the assessment of graft “quality” prior to transplantation.