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Evaluation Using an Isolated Reperfusion Model for Porcine Liver Donated After Cardiac Death Preserved with Oxygenated Hypothermic Machine Perfusion.
Ann Transplant 2018; 23:822-827AT

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.

Authors+Show Affiliations

Department of Mechanical Engineering, Tokyo Metropolitan University, Hachioji, Tokyo, Japan.Department of Mechanical Engineering, Tokyo Metropolitan University, Hachioji, Tokyo, Japan. Department of Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan. National Center for Child Health and Development, Setagaya, Tokyo, Japan.Department of Mechanical Engineering, Tokyo Metropolitan University, Hachioji, Tokyo, Japan.Department of Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.Department of Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.Department of Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.Department of Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.Department of Pathology, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.National Center for Child Health and Development, Setagaya, Tokyo, Japan.Department of Clinical Pharmacology, Tokyo University of Pharmacy and Life Sciences, Hachioji, Tokyo, Japan.Department of Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.Department of Mechanical Engineering, Tokyo Metropolitan University, Hachioji, Tokyo, Japan. National Center for Child Health and Development, Setagaya, Tokyo, Japan.

Pub Type(s)

Evaluation Studies
Journal Article

Language

eng

PubMed ID

30478252

Citation

Yoshikawa, Ryo, et al. "Evaluation Using an Isolated Reperfusion Model for Porcine Liver Donated After Cardiac Death Preserved With Oxygenated Hypothermic Machine Perfusion." Annals of Transplantation, vol. 23, 2018, pp. 822-827.
Yoshikawa R, Matsuno N, Morito N, et al. Evaluation Using an Isolated Reperfusion Model for Porcine Liver Donated After Cardiac Death Preserved with Oxygenated Hypothermic Machine Perfusion. Ann Transplant. 2018;23:822-827.
Yoshikawa, R., Matsuno, N., Morito, N., Gouchi, M., Otani, M., Takahashi, H., ... Obara, H. (2018). Evaluation Using an Isolated Reperfusion Model for Porcine Liver Donated After Cardiac Death Preserved with Oxygenated Hypothermic Machine Perfusion. Annals of Transplantation, 23, pp. 822-827. doi:10.12659/AOT.910008.
Yoshikawa R, et al. Evaluation Using an Isolated Reperfusion Model for Porcine Liver Donated After Cardiac Death Preserved With Oxygenated Hypothermic Machine Perfusion. Ann Transplant. 2018 Nov 27;23:822-827. PubMed PMID: 30478252.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluation Using an Isolated Reperfusion Model for Porcine Liver Donated After Cardiac Death Preserved with Oxygenated Hypothermic Machine Perfusion. AU - Yoshikawa,Ryo, AU - Matsuno,Naoto, AU - Morito,Noriyuki, AU - Gouchi,Mikako, AU - Otani,Masahide, AU - Takahashi,Hiroyuki, AU - Shonaka,Tatsuya, AU - Nishikawa,Yuji, AU - Enosawa,Shin, AU - Hirano,Toshihiko, AU - Furukawa,Hiroyuki, AU - Obara,Hiromichi, Y1 - 2018/11/27/ PY - 2018/11/28/entrez PY - 2018/11/28/pubmed PY - 2019/4/4/medline SP - 822 EP - 827 JF - Annals of transplantation JO - Ann. Transplant. VL - 23 N2 - 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. SN - 2329-0358 UR - https://www.unboundmedicine.com/medline/citation/30478252/Evaluation_Using_an_Isolated_Reperfusion_Model_for_Porcine_Liver_Donated_After_Cardiac_Death_Preserved_with_Oxygenated_Hypothermic_Machine_Perfusion_ L2 - https://www.annalsoftransplantation.com/download/index/idArt/910008 DB - PRIME DP - Unbound Medicine ER -