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Rewarming preservation by organ perfusion system for donation after cardiac death liver grafts in pigs.
Transplant Proc 2014; 46(4):1095-8TP

Abstract

BACKGROUND

Use of grafts from donors after cardiac death (DCD) would greatly contribute to the expansion of the donor organ pool. However, this requires the development of novel preservation methods to recover the organ from changes due to warm ischemia time (WIT).

METHODS

Porcine livers were perfused with a newly developed machine perfusion (MP) system. The livers were perfused with modified University of Wisconsin solution (UW) - gluconate. All grafts were procured after acute hemorrhagic shock with the ventilator off. For group 1 (n = 6), grafts were procured after WIT of 60 minutes and preserved by hypothermic MP (HMP) for 3 hours. For group 2 (n = 5), grafts were preserved with 2 hours of simple cold storage (SCS) and HMP for 2 hours. For group 3 (n = 6), grafts were preserved with 2 hours of SCS and rewarming up to 25°C by MP for 2 hours (RMP). The preserved liver grafts were transplanted orthotopically.

RESULTS

The alanine aminotransferase level in perfusate in RMP during perfusion preservation was maintained at less than that of HMP. The levels of aspartate aminotransferase and lactate dehydrogenase in the 2 hours after reperfusion were significantly lower in group 3. Histologically, the necrosis of hepatocytes was less severe in group 3. The survival rate in group 3 was 2/4, but 0/4 in the other group.

CONCLUSION

RMP is expected to facilitate the recovery of the DCD liver grafts.

Authors+Show Affiliations

National Center for Child Health and Development, Tokyo, Japan; Tokyo Metropolitan University, Mechanical Engineering, Tokyo, Japan. Electronic address: mtnnot@yahoo.co.jp.Tokyo Metropolitan University, Mechanical Engineering, Tokyo, Japan.National Center for Child Health and Development, Tokyo, Japan.National Center for Child Health and Development, Tokyo, Japan.National Center for Child Health and Development, Tokyo, Japan.National Center for Child Health and Development, Tokyo, Japan.Tokyo University of Pharmacology and Life Science, Clinical Pharmacology, Tokyo, Japan.National Center for Child Health and Development, Tokyo, Japan.National Center for Child Health and Development, Tokyo, Japan.

Pub Type(s)

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

Language

eng

PubMed ID

24815137

Citation

Matsuno, N, et al. "Rewarming Preservation By Organ Perfusion System for Donation After Cardiac Death Liver Grafts in Pigs." Transplantation Proceedings, vol. 46, no. 4, 2014, pp. 1095-8.
Matsuno N, Obara H, Watanabe R, et al. Rewarming preservation by organ perfusion system for donation after cardiac death liver grafts in pigs. Transplant Proc. 2014;46(4):1095-8.
Matsuno, N., Obara, H., Watanabe, R., Iwata, S., Kono, S., Fujiyama, M., ... Enosawa, S. (2014). Rewarming preservation by organ perfusion system for donation after cardiac death liver grafts in pigs. Transplantation Proceedings, 46(4), pp. 1095-8. doi:10.1016/j.transproceed.2013.12.035.
Matsuno N, et al. Rewarming Preservation By Organ Perfusion System for Donation After Cardiac Death Liver Grafts in Pigs. Transplant Proc. 2014;46(4):1095-8. PubMed PMID: 24815137.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rewarming preservation by organ perfusion system for donation after cardiac death liver grafts in pigs. AU - Matsuno,N, AU - Obara,H, AU - Watanabe,R, AU - Iwata,S, AU - Kono,S, AU - Fujiyama,M, AU - Hirano,T, AU - Kanazawa,H, AU - Enosawa,S, PY - 2013/09/30/received PY - 2013/12/03/revised PY - 2013/12/11/accepted PY - 2014/5/13/entrez PY - 2014/5/13/pubmed PY - 2015/1/3/medline SP - 1095 EP - 8 JF - Transplantation proceedings JO - Transplant. Proc. VL - 46 IS - 4 N2 - BACKGROUND: Use of grafts from donors after cardiac death (DCD) would greatly contribute to the expansion of the donor organ pool. However, this requires the development of novel preservation methods to recover the organ from changes due to warm ischemia time (WIT). METHODS: Porcine livers were perfused with a newly developed machine perfusion (MP) system. The livers were perfused with modified University of Wisconsin solution (UW) - gluconate. All grafts were procured after acute hemorrhagic shock with the ventilator off. For group 1 (n = 6), grafts were procured after WIT of 60 minutes and preserved by hypothermic MP (HMP) for 3 hours. For group 2 (n = 5), grafts were preserved with 2 hours of simple cold storage (SCS) and HMP for 2 hours. For group 3 (n = 6), grafts were preserved with 2 hours of SCS and rewarming up to 25°C by MP for 2 hours (RMP). The preserved liver grafts were transplanted orthotopically. RESULTS: The alanine aminotransferase level in perfusate in RMP during perfusion preservation was maintained at less than that of HMP. The levels of aspartate aminotransferase and lactate dehydrogenase in the 2 hours after reperfusion were significantly lower in group 3. Histologically, the necrosis of hepatocytes was less severe in group 3. The survival rate in group 3 was 2/4, but 0/4 in the other group. CONCLUSION: RMP is expected to facilitate the recovery of the DCD liver grafts. SN - 1873-2623 UR - https://www.unboundmedicine.com/medline/citation/24815137/Rewarming_preservation_by_organ_perfusion_system_for_donation_after_cardiac_death_liver_grafts_in_pigs_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0041-1345(13)01431-0 DB - PRIME DP - Unbound Medicine ER -