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Oxygenated Hypothermic Machine Perfusion After Static Cold Storage Improves Hepatobiliary Function of Extended Criteria Donor Livers.
Transplantation 2016; 100(4):825-35T

Abstract

BACKGROUND

The mechanism through which oxygenated hypothermic machine perfusion (HMP) improves viability of human extended criteria donor (ECD) livers is not well known. Aim of this study was to examine the benefits of oxygenated HMP after static cold storage (SCS).

METHODS

Eighteen ECD livers that were declined for transplantation underwent ex situ viability testing using normothermic (37 °C) machine perfusion (NMP) after traditional SCS (0 °C-4 °C) for 7 to 9 hours. In the intervention group (n = 6), livers underwent 2 hours of oxygenated HMP (at 12 °C) after SCS and before NMP. Twelve control livers underwent NMP without oxygenated HMP after SCS.

RESULTS

During HMP, hepatic ATP content increased greater than 15-fold, and levels remained significantly higher during the first 4 hours of NMP in the HMP group, compared with controls. Cumulative bile production and biliary secretion of bilirubin and bicarbonate were significantly higher after HMP, compared with controls. In addition, the levels of lactate and glucose were less elevated after HMP compared with SCS preservation alone. In contrast, there were no differences in levels of hepatobiliary injury markers AST, ALT, LDH, and gamma-GT after 6 hours of NMP. Hepatic histology at baseline and after 6 hours of NMP revealed no differences in the amount of ischemic necrosis between both groups.

CONCLUSIONS

Two hours of oxygenated HMP after traditional SCS restores hepatic ATP levels and improves hepatobiliary function but does not reduce (preexisting) hepatobiliary injury in ECD livers.

Authors+Show Affiliations

1 Surgical Research Laboratory, Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. 2 Section of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. 3 Department of Pathology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.No 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 availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26863473

Citation

Westerkamp, Andrie C., et al. "Oxygenated Hypothermic Machine Perfusion After Static Cold Storage Improves Hepatobiliary Function of Extended Criteria Donor Livers." Transplantation, vol. 100, no. 4, 2016, pp. 825-35.
Westerkamp AC, Karimian N, Matton AP, et al. Oxygenated Hypothermic Machine Perfusion After Static Cold Storage Improves Hepatobiliary Function of Extended Criteria Donor Livers. Transplantation. 2016;100(4):825-35.
Westerkamp, A. C., Karimian, N., Matton, A. P., Mahboub, P., van Rijn, R., Wiersema-Buist, J., ... Porte, R. J. (2016). Oxygenated Hypothermic Machine Perfusion After Static Cold Storage Improves Hepatobiliary Function of Extended Criteria Donor Livers. Transplantation, 100(4), pp. 825-35. doi:10.1097/TP.0000000000001081.
Westerkamp AC, et al. Oxygenated Hypothermic Machine Perfusion After Static Cold Storage Improves Hepatobiliary Function of Extended Criteria Donor Livers. Transplantation. 2016;100(4):825-35. PubMed PMID: 26863473.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Oxygenated Hypothermic Machine Perfusion After Static Cold Storage Improves Hepatobiliary Function of Extended Criteria Donor Livers. AU - Westerkamp,Andrie C, AU - Karimian,Negin, AU - Matton,Alix P M, AU - Mahboub,Paria, AU - van Rijn,Rianne, AU - Wiersema-Buist,Janneke, AU - de Boer,Marieke T, AU - Leuvenink,Henri G D, AU - Gouw,Annette S H, AU - Lisman,Ton, AU - Porte,Robert J, PY - 2016/2/11/entrez PY - 2016/2/11/pubmed PY - 2016/8/9/medline SP - 825 EP - 35 JF - Transplantation JO - Transplantation VL - 100 IS - 4 N2 - BACKGROUND: The mechanism through which oxygenated hypothermic machine perfusion (HMP) improves viability of human extended criteria donor (ECD) livers is not well known. Aim of this study was to examine the benefits of oxygenated HMP after static cold storage (SCS). METHODS: Eighteen ECD livers that were declined for transplantation underwent ex situ viability testing using normothermic (37 °C) machine perfusion (NMP) after traditional SCS (0 °C-4 °C) for 7 to 9 hours. In the intervention group (n = 6), livers underwent 2 hours of oxygenated HMP (at 12 °C) after SCS and before NMP. Twelve control livers underwent NMP without oxygenated HMP after SCS. RESULTS: During HMP, hepatic ATP content increased greater than 15-fold, and levels remained significantly higher during the first 4 hours of NMP in the HMP group, compared with controls. Cumulative bile production and biliary secretion of bilirubin and bicarbonate were significantly higher after HMP, compared with controls. In addition, the levels of lactate and glucose were less elevated after HMP compared with SCS preservation alone. In contrast, there were no differences in levels of hepatobiliary injury markers AST, ALT, LDH, and gamma-GT after 6 hours of NMP. Hepatic histology at baseline and after 6 hours of NMP revealed no differences in the amount of ischemic necrosis between both groups. CONCLUSIONS: Two hours of oxygenated HMP after traditional SCS restores hepatic ATP levels and improves hepatobiliary function but does not reduce (preexisting) hepatobiliary injury in ECD livers. SN - 1534-6080 UR - https://www.unboundmedicine.com/medline/citation/26863473/Oxygenated_Hypothermic_Machine_Perfusion_After_Static_Cold_Storage_Improves_Hepatobiliary_Function_of_Extended_Criteria_Donor_Livers_ L2 - http://dx.doi.org/10.1097/TP.0000000000001081 DB - PRIME DP - Unbound Medicine ER -