The Role of Allopurinol and Oxygen Free Radical Scavengers in Liver Preservation

The increased use of long-distance procurement for donor livers has recently created a dire need for prolonged hepatic preservation. To date, a variety of experimental liver preservation techniques have been studied; however, consistent success for more than 12 hours has yet to be achieved.1–3 Methods for testing the efficacy of preservation solutions that successfully and safely prolong the cold preservation time are needed and might offer a realistic solution to this problem. Toledo-Pereyra et al.4,5 and Lambotte et al.6 have suggested that the use of hyperosmolar perfusates may be beneficial in achieving prolonged hepatic cold-storage times. In addition, Toledo-Pereyra et al4 and Fuller et al 7 have reported on enhanced hypothermic preservation of donor livers following the use of pulsatile perfusion with specially made perfusates. Nevertheless, the vulnerability of the liver to both warm and cold ischemic damage and reperfusion injury remains as the major obstacle to immediate posttransplantation graft function.