Eleonora Björkman², Mihai Oltean¹, Anna Casselbrand², Michael Olausson¹, Gustaf Herlenius¹

¹Sahlgrenska Transplant Institute, Sahlgrenska University Hospital, Gothenburg, Sweden; ²Gastrosurgical research, University of Gothenburg, Gothenburg, Sweden

The efficiency of UW-Viaspan and HTK solutions for intestinal preservation is still disputed and various comparisons are ongoing. The cold storage alters the structure and function of the epithelial tight junction and results in progressive morphological alterations,  increased permeability, subepithelial edema and mucosal injury.  We studied several epithelial functional changes during the cold storage of rat intestines.

Rat intestines were stored in UW and HTK solutions for 8 and 14 hours. Mucosal permeability, epithelial resistance and brush-border dissacharidase activity (maltase, sucrose) were analyzed over time.

 In both groups, 8h of preservation induced moderate subepithelial edema (Park grade 2-3); the edema progressed but the epithelial continuity was maintained after 14h. Permeability for fluorescein and FD4 increased but did not differ significantly between groups. Potential difference decreased over time significantly more in the HTK grafts both at 8h (-0.671 mVvs -0.09 mV, p<0,001) and 14h (-0.497 vs -0.27mV, p<0,001). The decrease in epithelial resistance (reflecting the injury of the tight junction complex) was similar between groups. Maltase activity slightly decreased over time and was found significantly lower in the HTK group (p<0,001).

Despite comparable morphologic injury, short time (<14h) intestinal preservation with HTK seem to result in more advanced epithelial functional impairment.