Cryopreservation is increasingly used for long-term storage of viable cells and tissues. However, both freezing and thawing processes result in severe damages and tissue injury (
22,
23). Different mechanisms, such as oxidative stress, ice crystal formation with osmotic injury, activation of caspase-3 with apoptosis and disturbed ion homeostasis due to Na + /K+-ATPase pump inhibition, are responsible for cell damage during freeze-thaw processes (
24,
25). Cryoprotective substances, such as dimethyl sulfoxide (DMSO), glycerol, ethylene glycol and hydroxyethyl starch, protect cells from dehydration and prevent lethal intracellular ice formation which occurs during freezing (
23). However, these agents are toxic for cells and are needed to be rapidly eliminated after freezing (
26). DMSO also causes an osmotic stress which affects cells metabolic activity (
23,
27). Therefore, cryopreserved cells do not have the metabolic state of fresh cells. Functional activity of major enzymes which are involved in hepatocyte metabolism maintains after cryopreservation except in case of rapid activity loss of cytochrome P450 (P450) (
10,
28). To eliminate this problem, sugars and caspase inhibitor have been used to increase the stability of the hepatocyte (
10,
29,
30). Grondin et al. revealed that using crude wheat protein extract as a cryoprotective substance improves the hepatocyte specific functions and allows hepatocytes to be maintained in culture for 4 days (
31). Its effect was due to the presence of a mixture of materials, such as sugars and antioxidants, in the plant extract (
31). Hepatocyte viability was evaluated immediately after isolation by using the standard Trypan Blue exclusion technique. The cells which excluded Trypan Blue were considered as “viable” and cells staining blue were “dead.” In this assay, false negative result was occurred. In fact, when cells have intact cell membranes, but have initiated apoptotic pathways, they might not stain with Trypan Blue but they are ultimately dead (
30,
31). Despite its common use, it is not able to detect the cells undergoing apoptosis and, on the other hand, in vitro cell viability assay cannot predict the cell function after transplantation (
32). There are other alternative tests which can be used to evaluate the viability and activity of the isolated hepatocytes, such as MTT assay, measurement of cytochrome P450 activity, protein synthesis assay using [14C]-leucine incorporation, DNA synthesis assay using incorporation of [3H]-thymidine, and measuring hepatic marker proteins such as albumin, transferrin, and apolipoproteins (
32). These tests are believed to be more sensitive than Trypan Blue and reflect cells activity and function much better (
32). However, these methods are usually suitable for attached cells. If cell suspension is used, the major problem is to determine the dead cells. Ideally, viable cells must be separated from the dead ones by the Percoll gradient centrifugation and then tested with the aforementioned assays (
28). In fact, the Percoll gradient resulted in lower yield along with higher viable cells, which was suitable for any cell experiment (
31,
32). These methods are time consuming and decline the cell viability (
32). In our study, the viability after thawing of the control cryopreserved hepatocytes was 44%. This finding is in line with the study performed by Terry et al. reporting 45% viability after thawing of the control group (
33). In the current study, Williams’ culture medium E was used in freezing medium, while in the literature, University of Wisconsin solution (UW solution) has been recommended (
13,
32,
33). The study results showed that using fructose improves the viability after thawing of the cells (both primary cells and cell line). After preincubation with DTT (250 and 500 μM), the cell viability, attachment efficacy and function were significantly increased. Terry et al. have shown that incubation of hepatocytes with glucose, fructose, or α-lipoic acid prior to freezing improves the post thaw viability and function of the hepatocytes (
33). Fructose can protect the hepatocytes against apoptosis by forming nicotinamide adenine dinucleotide phosphate (NADPH) to regenerate the reduced glutathione (GSH). This event reduces the generation of reactive oxygen species and affects the survival (
34). Using fructose during hepatocyte isolation improves the recovery of energy by cells after ischemia reperfusion injury and cell isolation stress (
33). GSH as an important component of cellular antioxidant defense mechanism, plays a crucial role in protecting cells against oxidative stress, and is essential for cell functions and survival. DTT directly reduces the thiol groups and protects the cells against oxidative damage (
35,
36). Intracellular GSH content was significantly depleted before cell death and these cells were more sensitive to damage when exposed to toxic chemicals (
35,
36). Stevenson et al. found that during cryopreservation, the intracellular reduced glutathione was significantly decreased and adding ascorbic acid and α-tocopherol improved the content of reduced glutathione in postcryopreserved hepatocytes during freezing (
37,
38). The findings of the current study indicated that prolonged incubation with DTT was toxic for the cells; therefore, lower concentration with short preincubation is recommended. Moreover, the freeze-thaw process was associated with caspase activation and apoptosis had an important role in the cryoinjury of the cells. Stroh et al. found that using caspase inhibitors, such as zVAD-fmk, improves the recovery and survival of the cryopreserved cell lines and hematopoietic progenitor cells. They revealed that adding zVAD-fmk to both the freezing solution and the culture medium was protective during the thaw process (
39). Gauthaman et al. showed that using Rho-associated kinase (ROCK) inhibitor Y-27632 inhibited the apoptosis and increased the proliferation of the frozen-thawed human umbilical cord Wharton's jelly stem cells (
40). In addition, Y-27632 increased the survival of human embryonic stem cells after thawing significantly (
41). In this study, we used fresh rat hepatocytes and human HepG2 cell line to compare the primary cell and the cell line. However, it would have been more appropriate to use a human immortalized normal hepatocyte cell line, such as HepaRG cells, which retains many characteristics of the primary human hepatocytes. Using caspase inhibitor or ROCK inhibitor may improve the survival of hepatocytes after thawing. Of course, performing further experiments with other cryoprotective agents for cryopreservation of the primary human hepatocyte is important for the success of cell and tissue transplantation as well as tissue engineering. Cryopreservation is important for hepatocyte storing, but adversely affects the function and cell viability after thawing. Preincubation with fructose and DTT prior to cryopreservation increase both cell viability and hepatocyte function upon thawing. Of course, further studies are recommended to evaluate the effect of these substances on viability and function of the human hepatocytes.