Advantages of normothermic perfusion over cold storage in liver preservation

Imber, Charles; Peter, Shawn D. St.; Cenarruzabeitia, Íñigo López de; Pigott, D; James, Tim; Taylor, Richard; McGuire, James; Hughes, David; Butler, Andrew; Rees, Michael; Friend, Peter J.

doi:10.1097/00007890-200203150-00008

Cited by 204 publications

(189 citation statements)

References 27 publications

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“…However, there is an obvious problem that recipients are greatly more than donors. The disparity between the increasing demand for liver donors and the limited supply of donor organs has led to a reconsideration of the use of marginal pools, such as NHBD [25][26][27] . NHBD programs have been used successfully in kidney transplantation, and were able to increase donor pool of kidneys by 40%.…”

Section: Discussionmentioning

confidence: 99%

Safe time to warm ischemia and posttransplant survival of liver graft from non-heart-beating donors

He¹

2004

WJG

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AIM:To explore the dynamical changes of histology, histochemistry, energy metabolism, liver microcirculation, liver function and posttransplant survival of liver graft in rats under different warm ischemia times (WIT) and predict the maximum limitation of liver graft to warm ischemia. METHODS:According to WIT, the rats were randomized into 7 groups, with WIT of 0, 10, 15, 20, 30, 45, 60 min, respectively. The recovery changes of above-mentioned indices were observed or measured after liver transplantation. The graft survival and postoperative complications in each subgroup were analyzed. RESULTS:Liver graft injury was reversible and gradually resumed normal structure and function after reperfusion when WIT was less than 30 min. In terms of graft survival, there was no significant difference between subgroups within 30 min WIT. When WIT was prolonged to 45 min, the recipients' long-term survival was severely insulted, and both function and histological structure of liver graft developed irreversible damage when WIT was prolonged to 60 min. CONCLUSION:The present study indicates that rat liver graft can be safely subjected to warm ischemia within 30 min. The levels of ATP, energy charge, activities of glycogen, enzyme-histochemistry of liver graft and its recovery potency after reperfusion may serve as the important criteria to evaluate the quality of liver graft.

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Section: Discussionmentioning

confidence: 99%

Safe time to warm ischemia and posttransplant survival of liver graft from non-heart-beating donors

He¹

2004

WJG

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“…Numerous studies have demonstrated the advantage of NMP over CS in the preservation of DCD livers (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18), suggesting that NMP may greatly benefit the practice of liver transplantation. conducted using whole blood (WB) (9)(10)(11)(19)(20)(21). The same group recently introduced NMP in human liver transplantation using blood and additives during perfusion (18).…”

Section: Introductionmentioning

confidence: 99%

Comparing Normothermic Machine Perfusion Preservation With Different Perfusates on Porcine Livers From Donors After Circulatory Death

Liu

Nassar

Farias

et al. 2016

American Journal of Transplantation

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The utilization of normothermic machine perfusion (NMP) may be an effective strategy to resuscitate livers from donation after circulatory death (DCD). There is no consensus regarding the efficacy of different perfusates on graft and bile duct viability. The aim of this study was to compare, in an NMP porcine DCD model, the preservation potential of three different perfusates. Twenty porcine livers with 60 min of warm ischemia were separated into four preservation groups: cold storage (CS), NMP with Steen solution (Steen; XVIVO Perfusion Inc., Denver, CO), Steen plus red blood cells (RBCs), or whole blood (WB). All livers were preserved for 10 h and reperfused to simulate transplantation for 24 h. During preservation, the NMP with Steen group presented the highest hepatocellular injury. At reperfusion, the CS group had the lowest bile production and the worst hepatocellular injury compared with all other groups, followed by NMP with Steen; the Steen plus RBC and WB groups presented the best functional and hepatocellular injury outcomes, with WB livers showing lower aspartate aminotransferase release and a trend toward better results for most parameters. Based on our results, a perfusate that contains an oxygen carrier is most effective in a model of NMP porcine DCD livers compared with Steen solution. Specifically, WB-perfused livers showed a trend toward better outcomes compared with Steen plus RBCs.

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“…These data are mainly based on organ retrieval, preservation, ex-situ-evaluation and transplantation in large animal models (pigs). In the experimental setting normothermic perfusion has been shown to resuscitate porcine livers subjected to 60 to 90 minutes of warm ischaemia [14,29]. Warm perfusion has the added advantage of allowing more effective viability assessment of the organs while on the circuit (using multiple perfusion dynamic and biochemical parameters), contrasting with the more limited parameters available on the hypothermic circuit [27].…”

Section: Normothermic Machine Perfusion (Nmp)mentioning

confidence: 99%

“…The initial preservation experiments were carried out to compare preservation by warm perfusion with conventional cold preservation [29]. Porcine livers were retrieved and stored for a period of 24 hours, either flushed with UW solution and placed in an icebox or attached immediately to the preservation circuit.…”

Section: Preclinical Investigationsmentioning

confidence: 99%

A multicentre randomised controlled trial to compare the efficacy of ex-vivo normothermic machine perfusion with static cold storage in human liver transplantation

Nasralla¹,

Akhtar²,

Bradley³

et al. 2018

Protocol Exchange

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Advantages of normothermic perfusion over cold storage in liver preservation

Abstract: Normothermic sanguineous oxygenated perfusion is a superior method of preservation compared with simple cold storage in UW solution. In addition, perfusion allows the possibility to assess viability of the graft before transplantation.

Cited by 204 publications

References 27 publications

Safe time to warm ischemia and posttransplant survival of liver graft from non-heart-beating donors

Safe time to warm ischemia and posttransplant survival of liver graft from non-heart-beating donors

Comparing Normothermic Machine Perfusion Preservation With Different Perfusates on Porcine Livers From Donors After Circulatory Death

A multicentre randomised controlled trial to compare the efficacy of ex-vivo normothermic machine perfusion with static cold storage in human liver transplantation

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