Real-time assessments of liver quality in cold ischemia injury based on the technique of laser scanning confocal microscope

Objective To assess the quality of donor liver allografts by employing laser scanning confocal microscope (LSCM) and clinical liver function tests. Methods Sprague-Dawley rats were used for establishing cold ischemia models of liver allografts. According to different timepoints of cold ischemia, four groups of CIT1h, CIT6h, CIT12h and CIT24h were designated. At the end of cold ischemia time (CIT) of each group, perfusion and preservation fluids were collected and fluoresceins perfused. After LSCM examinations, tissue samples were harvested for HE examination. Finally a comparison was made between LSCM results and hematoxylin & eosin (HE) examinations. Also some relevant clinical parameters were detected in preserving and flushing fluids. Results Both LSCM examination and pathological examination indicated that the quality of liver allografts decreased significantly with the elapsing of time. Only the difference of LDH was statistically significant (P<0.001). Conclusions LSCM may be used for evaluating the ex vivo qualities of liver allografts. Simple handling and time efficiency re great advantages of LSCM. As compared with alanine transaminase (ALT) and aspartate transaminase (AST), LDH is a better indicator reflecting the quality of liver allografts. Key words: Donor; Liver; Cold ischemia; Laser scanning confocal microscope; Assessment; Liver function; Lactate dehydrogenase