Tags

Type your tag names separated by a space and hit enter

Hypothermic oxygenated machine perfusion in porcine donation after circulatory determination of death liver transplant.
Transplantation. 2012 Jul 15; 94(1):22-9.T

Abstract

BACKGROUND

Livers from donation after circulatory determination-of-death (DCD) donors suffer ischemic injury during a preextraction period of cardiac arrest and are infrequently used for transplantation; they have the potential, however, to considerably expand the donor pool. We aimed to determine whether hypothermic oxygenated machine perfusion would improve or further deteriorate the quality of these livers using a clinically relevant porcine model.

METHODS

Donor livers were subjected to 90 min of cardiac arrest and preserved at 4°C with either static cold storage using University of Wisconsin solution (CS, n=6) or oxygenated machine perfusion using University of Wisconsin machine perfusion solution and 25% physiological perfusion pressures (HMP, n=5). After 4 hr of preservation, livers were transplanted into recipient pigs, which were followed intensively for up to 5 days.

RESULTS

Five-day survival was 0 in CS and 20% in HMP. Immediately after reperfusion, hepatocellular injury and function were improved in HMP versus CS. However, HMP grafts also demonstrated significant endothelial and Kupffer cell injury, and a progressive lesion developed 24 to 48 hr after reperfusion that led to death in all but one of the recipient animals.

CONCLUSIONS

Although hypothermic oxygenated machine perfusion performed using subphysiological perfusion pressures seems to offer some advantages over cold storage in the preservation of ischemically damaged livers, it simultaneously conditions endothelial and Kupffer cell injury that may ultimately lead to the failure of these grafts.

Authors+Show Affiliations

Liver Transplant Unit, Institut de Malaties Digestives, Hospital Clinic, CIBERehd, IDIBAPS, University of Barcelona, C/Villaroel 170, Barcelona, Spain. cfonde@clinic.ub.esNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

22691959

Citation

Fondevila, Constantino, et al. "Hypothermic Oxygenated Machine Perfusion in Porcine Donation After Circulatory Determination of Death Liver Transplant." Transplantation, vol. 94, no. 1, 2012, pp. 22-9.
Fondevila C, Hessheimer AJ, Maathuis MH, et al. Hypothermic oxygenated machine perfusion in porcine donation after circulatory determination of death liver transplant. Transplantation. 2012;94(1):22-9.
Fondevila, C., Hessheimer, A. J., Maathuis, M. H., Muñoz, J., Taurá, P., Calatayud, D., Leuvenink, H., Rimola, A., García-Valdecasas, J. C., & Ploeg, R. J. (2012). Hypothermic oxygenated machine perfusion in porcine donation after circulatory determination of death liver transplant. Transplantation, 94(1), 22-9. https://doi.org/10.1097/TP.0b013e31825774d7
Fondevila C, et al. Hypothermic Oxygenated Machine Perfusion in Porcine Donation After Circulatory Determination of Death Liver Transplant. Transplantation. 2012 Jul 15;94(1):22-9. PubMed PMID: 22691959.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hypothermic oxygenated machine perfusion in porcine donation after circulatory determination of death liver transplant. AU - Fondevila,Constantino, AU - Hessheimer,Amelia J, AU - Maathuis,Mark-Hugo J, AU - Muñoz,Javier, AU - Taurá,Pilar, AU - Calatayud,David, AU - Leuvenink,Henri, AU - Rimola,Antoni, AU - García-Valdecasas,Juan C, AU - Ploeg,Rutger J, PY - 2012/6/14/entrez PY - 2012/6/14/pubmed PY - 2012/9/12/medline SP - 22 EP - 9 JF - Transplantation JO - Transplantation VL - 94 IS - 1 N2 - BACKGROUND: Livers from donation after circulatory determination-of-death (DCD) donors suffer ischemic injury during a preextraction period of cardiac arrest and are infrequently used for transplantation; they have the potential, however, to considerably expand the donor pool. We aimed to determine whether hypothermic oxygenated machine perfusion would improve or further deteriorate the quality of these livers using a clinically relevant porcine model. METHODS: Donor livers were subjected to 90 min of cardiac arrest and preserved at 4°C with either static cold storage using University of Wisconsin solution (CS, n=6) or oxygenated machine perfusion using University of Wisconsin machine perfusion solution and 25% physiological perfusion pressures (HMP, n=5). After 4 hr of preservation, livers were transplanted into recipient pigs, which were followed intensively for up to 5 days. RESULTS: Five-day survival was 0 in CS and 20% in HMP. Immediately after reperfusion, hepatocellular injury and function were improved in HMP versus CS. However, HMP grafts also demonstrated significant endothelial and Kupffer cell injury, and a progressive lesion developed 24 to 48 hr after reperfusion that led to death in all but one of the recipient animals. CONCLUSIONS: Although hypothermic oxygenated machine perfusion performed using subphysiological perfusion pressures seems to offer some advantages over cold storage in the preservation of ischemically damaged livers, it simultaneously conditions endothelial and Kupffer cell injury that may ultimately lead to the failure of these grafts. SN - 1534-6080 UR - https://www.unboundmedicine.com/medline/citation/22691959/Hypothermic_oxygenated_machine_perfusion_in_porcine_donation_after_circulatory_determination_of_death_liver_transplant_ L2 - https://doi.org/10.1097/TP.0b013e31825774d7 DB - PRIME DP - Unbound Medicine ER -