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

  • Luis H. Toledo-Pereyra
Part of the Basic Life Sciences book series (BLSC, volume 49)


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.


Xanthine Oxidase Preservation Solution Oxygen Free Radical Scavenger Liver Preservation Pulsatile Perfusion 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    L.H. Toledo-Pereyra, J. Castellanos, and M. Chapman, Failure to preserve liver allografts for 24 hours: Experimental and theoretical considerations, Transplant Proc. 19(Suppl 3):68 (1987).PubMedGoogle Scholar
  2. 2.
    L. Lambotte, S. Pontegnie-Istace, and J.B. Otte, The effect of isoproterenol and Collins’ solution on the preservation of canine livers with simple cooling, Transplant Proc. 6:301 (1974).PubMedGoogle Scholar
  3. 3.
    K.N. Mallik, I.C. Pathak, S.K. Mitra, D.V. Datta, R. Bhatara, and S. Garg, Preservation of liver for 4 to 20 hours by the cold flushing-freeze storage technique, Indian J. Med. Res. 71:468 (1980).PubMedGoogle Scholar
  4. 4.
    L.H. Toledo-Pereyra, R.L. Simmons, and J.S. Najarian, Factors deter-mining successful liver preservation for transplantation, Ann. Surg. 181:289 (1975).PubMedCrossRefGoogle Scholar
  5. 5.
    L.H. Toledo-Pereyra, M. Chee, R.C. Lillehei, and R.M. Condie, Liver preservation by cold storage with hyperosmolar solutions for twenty four hours, Cryobiology 16:43 (1979).PubMedCrossRefGoogle Scholar
  6. 6.
    L. Lambotte, S. Wojcik, and S. Pontegnie-Istace, Investigations on the mechanisms of action of hyperosmolar solutions used in liver preservation, in: “Organ Preservation II,” P.E. Pegg and I.A. Jacobsen, eds., Churchill Livingstone, Edinburgh (1979).Google Scholar
  7. 7.
    B.J. Fuller, and V.D. Attenburrow, The effects of increasing the on-cotic pressure of the perfusate on bloodless hypothermic perfusion of the liver in the rat, Cryobiology 15:545 (1978).PubMedCrossRefGoogle Scholar
  8. 8.
    J.M. McCord, Oxygen derived free radicals in postischemic tissue injury, N. Engl. J. Med. 312:159 (1985).PubMedCrossRefGoogle Scholar
  9. 9.
    R.P. Rizzuti, P.R. Cunningham, D. Easley, T. Fushiki, and F.T. Thomas, A new method of hepatic preservation using pulsatile perfusion and allopurinol, Current Surgery 43(6):492 (1986).PubMedGoogle Scholar
  10. 10.
    R.M. Merion, D.A. Campbell Jr., D.R. Averill Jr., D.C. Dafoe, J.C. Fantone, and J.G. Turcotte, Improved liver preservation with euro-collins and donor allopurinol, Transplant Proc. 18:582 (1986).Google Scholar
  11. 11.
    L.H. Toledo-Pereyra, R.L. Simmons, and J.S. Najarian, Protection of the ischemic liver by donor pretreatment before transplantation, Am. J. Surg. 129:513 (1975).PubMedCrossRefGoogle Scholar
  12. 12.
    D. Adkinson, M.E. Hollwarth, J.N. Benoit, D.A. Parks, J.M. McCord, and D.N. Granger, Role of free radicals in ischemia-reperfusion injury to the liver, Acta Physiol. Scand. Suppl 548:101 (1986).Google Scholar
  13. 13.
    S.L. Attala, L.H. Toledo-Pereyra, G.H. MacKenzie, and J.P. Cederna, Influence of oxygen-derived free radical scavengers on ischemic livers, Transplantation 40:584 (1985).CrossRefGoogle Scholar
  14. 14.
    L.H. Toledo-Pereyra, and J. Cederna, Protection of liver allografts from ischemic damage prior to transplantation using insulin and catalase, in: “Oxygen free radicals in shock,” G.P. Novelli and F. Ursini eds., S. Karger, Basel (1986).Google Scholar
  15. 15.
    S. Marubayashi, K. Dohi, K. Ochi, and T. Kawasaki, Role of free radicals in ischemic rat liver cell injury: Prevention of damage by α -tocopherol, Surgery 90:184 (1986).Google Scholar

Copyright information

© Plenum Press, New York 1988

Authors and Affiliations

  • Luis H. Toledo-Pereyra
    • 1
  1. 1.Departments of Surgery and Surgical ResearchMount Carmel Mercy HospitalDetroitUSA

Personalised recommendations