Danger Biomarkers in Perfusates From Fatty Liver Grafts Subjected to Cold Storage Preservation in Different Preservation Solutions

Static cold storage remains the traditional standard for liver graft preservation prior to transplantation in both clinical and experimental settings. The use of polyethylene glycol 35 solutions, such as Institut Georges Lopez-2 (IGL2) preservation solution, for protecting against mitochondrial damage during cold static preservation necessitates combination with hypothermic oxygenated perfusion to enhance liver graft performance. This study presents a preliminary comparative evaluation of "danger signals" indicating hepatocellular injury (transaminases, lactate content), mitochondrial damage (glutamate dehydrogenase release), and cytokine release in liver perfusates from suboptimal grafts (fatty livers) subjected to 24-hour cold storage. We refined an original IGL2 solution, referred to as IGL2-M solution, which was compared to HistidineTryptophan-Ketoglutarate preservation solution used as a control. The IGL2-M solution demonstrated superior efficacy in preventing hepatocellular and mitochondrial damage in vulnerable steatotic grafts against ischemia-reperfusion injury. The IGL2-M solution better preserved the quality of fatty liver grafts compared to the Histidine-Tryptophan-Ketoglutarate solution, as evidenced by fewer danger signals after 24 hours of cold static preservation. Further investigations are warranted to explore these findings in greater depth.