Efficient preservation of the donor liver during hepatic transplantation is of crucial importance. Good function of the liver is required immediately after transfer if the patient is to survive liver excision and replacement, because there is no effective means of support in the absence of hepatic function. With auxiliary liver transplantation good function is again required at an early time to reverse the effects of advanced liver failure. Nevertheless, in this situation, the recipient's own liver may retain sufficient function in the early postoperative period to allow the allograft to recover from temporary damage which occurs at the time of transplantation.
Laboratory experiments in dogs have shown that at normothermia the ischemic liver becomes unsuitable for transplantation after 20 to 30 minutes.1 If the donor is cooled to 30 C before death and the liver perfused from the time of death with cooled electrolyte solution, this time may be