Primary liver graft dysfunction is currently related to cold ischemia-
reperfusion injury, although a wide survival range has been reported using 24-hour preservation in cold University of Wisconsin (
UW) solution. We hypothesized that the portal vein clamping time (PVCT) played a more important role than cold preservation injury in the postoperative outcome. Rat
liver transplantation was performed using different clamping times after 24-hour cold ischemia in the
UW solution. Survival rates, plasma
tumor necrosis factor (TNF), and
nitrate/
nitrite levels were examined. Subsequently, the effect of clamping time was evaluated on hepatocyte and sinusoidal endothelial cell (SEC) function using isolated perfused livers. Survival rate was directly related to clamping time length. Marked increases in TNF and
nitrate/
nitrite levels were found after surgery, particularly after long clamping times. In perfusion studies, the SEC function was already markedly altered after preservation alone and was not further modified by
transplantation. By contrast, the hepatocyte function was moderately altered after
transplantation, irrespective of clamping times, even when rats operated with long clamping times were in terminal conditions. In rats, 24-hour preservation in cold
UW solution is not a severely compromising condition leading to primary liver nonfunction. Long PVCTs are associated with an
endotoxemia-like syndrome more related to a warm intestinal
ischemia than to cold ischemia injury of the liver.