C. M. Miller

Functional and morphological features of isolated hepatocytes preserved in University of Wisconsin solution.

Although several studies suggest that hepatic graft failure after cold ischemia results from nonparenchymal cell damage, other data indicate that hepatocellular ATP content is significantly correlated with the transplantation success rate. In this study, we have conducted a systematic investigation of various aspects of cell viability and function of isolated hepatocytes stored at 4°C for 24 and 48 hr in either University of Wisconsin solution or Hanks HEPES buffer, a control solution clinically unsuitable for organ preservation. After 24 hr, hepatocytes stored in Hanks HEPES buffer had viability (measured by trypan blue exclusion and ALT and lactic dehydrogenase leakage), transport function (measured by 22Na+ and [3H]taurocholate uptake) and cell size similar or only slightly altered when compared with freshly isolated and University of Wisconsin solution‐stored hepatocytes. ATP content was decreased in both groups; however, the reduction was much greater in Hanks HEPES buffer‐stored cells. Furthermore, ATP regenerating capacity was greatly reduced in Hanks HEPES buffer‐stored but not in University of Wisconsin solution‐stored hepatocytes. By 48 hr viability and function of Hanks HEPES buffer‐stored hepatocytes were decreased; University of Wisconsin solution afforded partial protection. When examined by light and electron microscopy, cells stored in both University of Wisconsin solution and Hanks HEPES buffer for 24 hr appeared essentially normal except for the presence of numerous membrane blebs in the Hanks HEPES buffer group. Tissue sections of livers preserved in Hanks HEPES buffer but not in University of Wisconsin solution revealed the presence of extensive amounts of blebs in the sinusoidal lumen and loss of endothelial elements. This study indicates that isolated hepatocytes are remarkably resistant to 24‐hr cold ischemia. However, the resulting low ATP levels may be responsible for formation of membrane blebs, the shedding of which, in vivo, may lead or contribute to microcirculatory disturbances. These findings may potentially explain the relationship between hepatocellular ATP content and regenerating capacity and the clinical outcome of liver transplantation. (HEPATOLOGY 1991;14:331–339.)

Giant varices in portal hypertension: CT findings

Two cases of giant varices in portal hypertension are presented. Dynamic computed tomography (CT) was useful in establishing that the masses were in fact dilated veins.

Resistant hepatic allograft rejection successfully treated with cyclophosphamide and plasmapheresis

We report 2 patients who underwent ABO compatible orthotopic liver transplantation with acute rejection that appears to be cellular ― as well as antibody-mediated