Disturbed microcirculation caused by fat accumulation in hepatocytes has been implicated in poor graft preservation and reperfusion. The aim of this study was to investigate the effect of vascular bed expansion (VBE) during cold preservation in graft survival Moderate liver steatosis in male Wistar rats (240-280 g) was induced by choline-deficient diet. Normal, steatotic or VBE-pretreated steatotic grafts were transplanted after 1 h or 9 h of cold preservation. Graft viability was determined by 7-day survival, serum liver enzymes, plasma tumour necrosis factor (TNF)-alpha, interleukin (IL)-6, and malondialdehyde (MDA) levels. Post-reperfusion bile flow and liver histology were also examined. After 9 h of preservation, VBE-pretreated steatotic liver grafts were associated with significantly reduced serum liver enzyme, plasma TNF-alpha, IL-6, and MDA levels, as well as increased bile flow and higher survival rates compared with untreated ones. The present study shows that VBE protects fatty liver grafts from subsequent long-term cold preservation and reperfusion injury in a rat liver transplantation model.

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