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. 2024 Mar 27;14:7328. doi: 10.1038/s41598-024-57773-w

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© The Author(s) 2024

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Portal vein pressure, ALT, and AST levels indicate higher injury to livers perfused with packed RBCs compared to acellular perfusate for the 3 h of perfusion. (a) Shows the trends in resistance for the tested conditions. It is significantly higher in the pRBC groups than the acellular perfusate groups after 2 h of perfusion. There is no significant difference between the fresh and cold storage groups for each type of perfusate. (b,c) Trends in ALT and AST levels between the four groups, where pRBC perfusate groups show higher values compared to the acellular perfusate groups. The statistically significant difference becomes more prominent over time for these groups. (d) Shows no significant difference in IVC potassium for all four groups during perfusion. (e) Shows hemolysis over the duration of perfusion. There is no significant difference at any time during the perfusion between 0 and 24h CI groups. The hemolysis is also evident from the increasing red coloration of the perfusate samples with time as shown in (f). Finally, (g), shows representative histology to show the patters of injury in 24hCI livers from acellular and pRBC groups stained with H&E and TUNEL stains (Magnification 20x). The blue arrows indicate hepatocyte death while the black arrows show endothelial death as observed via TUNEL staining of apoptotic cells. Each group has a 3–4 replocates. We plotted mean ± standard deviation for AST and hemolysis which followed normal distribution, and median ± IQR for resistance, ALT, and potassium which were observed to not follow a normal distribution. Statistical significance levels *p < 0.05, **p < 0.01, ***p < 0.005.