Background and Aims: The nutritional status of a donor is considered to be an important factor affecting organ viability. The purpose of the present study was to examine hepatic energy status in connection with posttransplantation liver function. Methods: The following five groups of donor rat livers were prepared and stored in University of Wisconsin solution at 4°C: fasted group, rats fasted for 24 hours; fed group, rats provided standard laboratory chow; fed plus insulin group, fed rats treated with insulin before harvest; fasted plus insulin group, fasted rats treated with insulin before harvest; and fed plus glucagon group, fed rats pretreated with glucagon. Results: Hepatic levels of adenosine triphosphate and total adenine nucleotides were maintained in the decreasing order of the fed plus insulin, fed, fasted plus insulin, fasted, and fed plus glucagon groups during preservation. Lactate production rate and fructose 2,6-bisphosphate level increased in the order of the fed plus insulin, fed, fed plus glucagon, fasted, and fasted plus insulin groups. Liver function after transplantation evaluated by the bile flow rate and enzyme leakage was well restored in the fed plus insulin group. Conclusions: Insulin administration to nutritionally well-supported livers before harvest improved energy metabolism during preservation and liver function after transplantation.
Morimoto, Y., Kamiike, W., Nishida, T., Hatanaka, N., Shimizu, S., Huang, P., … Matsuda, H. (1996). Improvement of rat liver graft function by insulin administration to donor. Gastroenterology, 111(4), 1071–1080. https://doi.org/10.1016/S0016-5085(96)70076-8