Protein Globule Formation in the Liver Graft during Cold Preservation for Liver Transplantation: Its Clinical and Pathological Significance

In liver transplantation, liver graft ischemia-reperfusion injury occurs mainly due to cold preservation and warm reperfusion. In this research, we study the affection of plasma protein of the donor on liver graft during cold preservation and warm reperfusion. In this study, 34 liver transplantations were performed from 2007 to 2010, and the clinical data were collected retrospectively from the Dongfang Hospital database. 34 specimens were harvested from 34 liver grafts when graft trimming as Group A and 34 specimens harvested from the same 34 liver grafts during liver transplantation surgery but before abdominal closure as B group. All liver tissue specimens were fixed with 40 g/L neutral formalin, embedded in paraffin. Light microscopy, transmission electron microscopy, Periodic Acid-Schiff (PAS) stain and immunohistochemical stain of IgG, IgM, IgA, C3d, C4d, Fib, C1q, and CD61 were used. In this study, we found that eosinophilic bodies emerged in liver lobes during liver transplantation which had not been reported previously in the literature. 1) Protein globules were found exclusively in liver graft specimens. The globules were round or oval with sharp edges, measured approximately 1.59 to 9.41 μm in diameter, and were scattered in the liver sinusoids or space of Disse or hepatocyte cytoplasm, were stained with IgG, IgM, IgA, Fib, C3d by immunohistochemical staining; 2) There was no statistical significant difference of protein globules number between A group and B group (P > 0.05); 3) IRI score of B group was not correlated with protein globules number (P > 0.05). Protein globules contain plasma composition, and may form during cold preservation.