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Influence of flow and addition of oxygen during porcine liver hypothermic machine perfusion.

Abstract

INTRODUCTION

In contrast with kidneys, data on hypothermic machine perfusion (HMP) of livers remain scarce. Optimal liver HMP is poorly defined. Superiority of liver HMP over simple cold storage (SCS), the current standard preservation, must be proven before HMP is applied clinically. In this study, morphology and adenosine triphosphate (ATP) contents of HMP livers at different flows and with versus without O(2) studied in a porcine ex vivo model were compared to SCS.

METHODS

Pig livers were procured, flushed with HTK and preserved via SCS or HMP at 3 HMP settings: high flow (HF); low flow (LF); low flow + O(2) (300 mm Hg) (LFO). HMP livers were perfused via the hepatic artery (HA) and portal vein (PV) with KPS-1 TM at 4 degrees C to 6 degrees C for 24 hours with HF: PV: 3 to 5 mm Hg, 1 mL/g liver/min for HA and 25 mm Hg; LF: PV: 3 to 5 mm Hg, 0.5 ml/g liver/min with HA: 20 mm Hg. Morphology and ATP levels were measured in preserved liver tissues.

RESULTS

Throughout the SCS preservation, livers remained intact. In HMP livers, vacuoles appeared after 4 hours of preservation in the HF group and after 12 hours in the LF livers. LFO livers remained intact with limited vacuoles. Compared to SCS, HMP livers showed dilated sinusoids, particularly in the HF group. ATP remained relatively constant or even increased during HMP, particularly in the LF group, whereas ATP decreased after SCS.

CONCLUSION

Among the various HMP settings, HMP with LFO was superior. ATP levels were the highest in LF. In contrast with all HMP groups, SCS showed the lowest ATP levels, indicating that HMP has the potential to better preserve energy stores.

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  • Authors+Show Affiliations

    ,

    Abdominal Transplant Surgery, Catholic University of Leuven, Herestraat 49, 3000 Leuven, Belgium. Katrien.vekemans@med.kuleuven.be

    , , , ,

    Source

    Transplantation proceedings 39:8 2007 Oct pg 2647-51

    MeSH

    Adenosine Triphosphate
    Animals
    Glucose
    Hepatic Artery
    Hypothermia
    Liver
    Mannitol
    Models, Animal
    Organ Preservation Solutions
    Oxygen Consumption
    Perfusion
    Potassium Chloride
    Procaine
    Swine

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    17954199

    Citation

    Vekemans, K, et al. "Influence of Flow and Addition of Oxygen During Porcine Liver Hypothermic Machine Perfusion." Transplantation Proceedings, vol. 39, no. 8, 2007, pp. 2647-51.
    Vekemans K, Liu Q, Brassil J, et al. Influence of flow and addition of oxygen during porcine liver hypothermic machine perfusion. Transplant Proc. 2007;39(8):2647-51.
    Vekemans, K., Liu, Q., Brassil, J., Komuta, M., Pirenne, J., & Monbaliu, D. (2007). Influence of flow and addition of oxygen during porcine liver hypothermic machine perfusion. Transplantation Proceedings, 39(8), pp. 2647-51.
    Vekemans K, et al. Influence of Flow and Addition of Oxygen During Porcine Liver Hypothermic Machine Perfusion. Transplant Proc. 2007;39(8):2647-51. PubMed PMID: 17954199.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Influence of flow and addition of oxygen during porcine liver hypothermic machine perfusion. AU - Vekemans,K, AU - Liu,Q, AU - Brassil,J, AU - Komuta,M, AU - Pirenne,J, AU - Monbaliu,D, PY - 2007/10/24/pubmed PY - 2007/12/7/medline PY - 2007/10/24/entrez SP - 2647 EP - 51 JF - Transplantation proceedings JO - Transplant. Proc. VL - 39 IS - 8 N2 - INTRODUCTION: In contrast with kidneys, data on hypothermic machine perfusion (HMP) of livers remain scarce. Optimal liver HMP is poorly defined. Superiority of liver HMP over simple cold storage (SCS), the current standard preservation, must be proven before HMP is applied clinically. In this study, morphology and adenosine triphosphate (ATP) contents of HMP livers at different flows and with versus without O(2) studied in a porcine ex vivo model were compared to SCS. METHODS: Pig livers were procured, flushed with HTK and preserved via SCS or HMP at 3 HMP settings: high flow (HF); low flow (LF); low flow + O(2) (300 mm Hg) (LFO). HMP livers were perfused via the hepatic artery (HA) and portal vein (PV) with KPS-1 TM at 4 degrees C to 6 degrees C for 24 hours with HF: PV: 3 to 5 mm Hg, 1 mL/g liver/min for HA and 25 mm Hg; LF: PV: 3 to 5 mm Hg, 0.5 ml/g liver/min with HA: 20 mm Hg. Morphology and ATP levels were measured in preserved liver tissues. RESULTS: Throughout the SCS preservation, livers remained intact. In HMP livers, vacuoles appeared after 4 hours of preservation in the HF group and after 12 hours in the LF livers. LFO livers remained intact with limited vacuoles. Compared to SCS, HMP livers showed dilated sinusoids, particularly in the HF group. ATP remained relatively constant or even increased during HMP, particularly in the LF group, whereas ATP decreased after SCS. CONCLUSION: Among the various HMP settings, HMP with LFO was superior. ATP levels were the highest in LF. In contrast with all HMP groups, SCS showed the lowest ATP levels, indicating that HMP has the potential to better preserve energy stores. SN - 0041-1345 UR - https://www.unboundmedicine.com/medline/citation/17954199/Influence_of_flow_and_addition_of_oxygen_during_porcine_liver_hypothermic_machine_perfusion_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0041-1345(07)00926-8 DB - PRIME DP - Unbound Medicine ER -