27 November 2018 : Original article
Evaluation Using an Isolated Reperfusion Model for Porcine Liver Donated After Cardiac Death Preserved with Oxygenated Hypothermic Machine Perfusion
Ryo Yoshikawa1ABCDEF, Naoto Matsuno123ABDEFG*, Noriyuki Morito1ABCDF, Mikako Gouchi2BCD, Masahide Otani2D, Hiroyuki Takahashi2D, Tatsuya Shonaka2D, Yuji Nishikawa4BCD, Shin Enosawa3AD, Toshihiko Hirano5AD, Hiroyuki Furukawa2AD, Hiromichi Obara13ABDEFGDOI: 10.12659/AOT.910008
Ann Transplant 2018; 23:822-827
Abstract
BACKGROUND: Machine perfusion techniques offer a solution to the serious organ shortage. However, to assess the effects of machine perfusion, many detailed studies are required. In this study, an ex vivo reperfusion model using diluted autologous blood was confirmed to evaluate the utility of machine preservation for livers donated after cardiac death (DCD). In particular, beneficial effects of the oxygenated hypothermic machine perfusion (HMP) for DCD porcine livers are evaluated.
MATERIAL AND METHODS: Porcine livers were procured under warm ischemia time (WIT) of 60 min. The livers were preserved by hypothermic machine perfusion (HMP) or static cold storage (CS) for 4 h. After the preservation, the livers were perfused for 2 h using the ex vivo reperfusion model with diluted blood oxygenated by a membrane oxygenator at 35–38°C.
RESULTS: At 2 h of ex vivo reperfusion with 60 min of warm ischemic time (WIT), the portal vein pressure for CS was higher than HMP (18.8±15.9 vs. 7.5±3.9 [mmHg] in 60 min). Furthermore, LDH in CS was higher than HMP (528.5±149.8 vs. 194.1±32.2 [IU/L/100 g liver] in 60 min. P<0.05). Lactate after CS (60) was significantly higher than HMP (60) (8.67±0.39 vs. 5.68±0.60 [mmol/L] at 60 min. p<0.01).
CONCLUSIONS: The ex vivo reperfusion model can be used to evaluate the utility of machine perfusion. Advantages of HMP for DCD livers are evaluated with this model.
Keywords: Liver Transplantation, Organ Preservation
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