Evaluation Using an Isolated Reperfusion Model for Porcine Liver Donated After Cardiac Death Preserved with Oxygenated Hypothermic Machine Perfusion

Abstract

BackgroundMachine 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/MethodsPorcine 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.ResultsAt 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).ConclusionsThe 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.

Impact of human-derived hemoglobin based oxygen vesicles as a machine perfusion solution for liver donation after cardiac death in a pig model

“…This review demonstrated that the Hct in the experiment is about 20%, but there are some that are higher or lower than that. Yoshikawa et al [19,34] showed the effectiveness of our evaluation system. Qiang Liu et al[35].…”

Beneficial effects of end-ischemic oxygenated machine perfusion preservation for split-liver transplantation in recovering graft function and reducing ischemia–reperfusion injury

“…The livers were evaluated by reperfusion with oxygenated diluted autologous blood at 38 °C rather than after transplantation. We reported that the ERM can be useful for evaluating MP utility 19 , 20 . This isolated ERM can reduce the need for animal transplantation experiments and the technical bias associated with the actual transplantation operation, and facilitate observation of hemodynamic changes (perfusion area and vascular pressure resistance) during reperfusion.…”

“…After preservation, the liver function was evaluated using an isolated liver reperfusion model 6 , 19 , 20 . This system consisted of HA and PV perfusion circuits, with each circuit comprising a roller-type pump (Masterflex 7520-40; Cole-Parmer, Bunker Court, IL, USA), electrical flow meter (VN05; Aichi Tokei, Aichi, Japan for the PV; FD-SS02; Keyence, Osaka, Japan for the HA), ceramic capacitive pressure sensor (KL76; Nagano Keiki, Nagano, Japan), and an air trap developed in-house.…”

Evaluation of the ex vivo liver viability using a nuclear magnetic resonance relaxation time-based assay in a porcine machine perfusion model

“…Machine perfusion was developed to improve the quality of preservation for donor grafts 8 , 18 – 21 . Two major perfusion strategies, hypothermic and normothermic techniques, are currently used in clinical settings 1 , 6 , 22 – 24 .…”