Ex vivo evaluation of porcine livers post-hypothermic machine perfusion at 4-6ºC and 12-14ºC

Abstract

Background: The goal of our research is the development of a clinical hypothermic machine perfusion method and device for liver preservation during storage and transport prior to transplantation. The purpose of this study was comparison of two hypothermic temperature ranges. Methods: Heart beating donor pig livers with 2h of static cold storage on ice were employed. Thirteen experimental livers were perfused, at either 4-6ºC or 12-14ºC with oxygenation, employing a prototype device. They were compared with six control 2h static cold stored livers during normothermic ex vivo blood perfusion. Physiological measurements and biochemical perfusate analyses were performed to assess the impact of storage conditions on liver functions. Statistics were assessed by one way analysis of variance, p<0.05 was regarded as significant. Results: During hypothermic perfusion perfusate solutes (Na

Reply

“…With regards to the synthetic function of livers on ex vivo machine perfusion, the production of albumin (7,8) and coagulation factors such as factor V (9)(10)(11) has been previously reported by other groups. As far as measurement of TG and lipids are concerned, previous studies have used the same methods for quantification of TG and LDL in the perfusate.…”

Indocyanine green: A novel marker for assessment of graft quality during ex situ normothermic machine perfusion of human livers

“…Despite widespread use in the evaluation of cirrhotic patients prior to hepatectomy and occasionally in the assessment of potential liver donors 19–21 and liver transplant recipients, 22 the use of ICG until now in the setting of ex situ machine perfusion has been limited 8 . In animal studies involving rats and pigs, ICG clearance has been used to assess the performance of hypothermic machine perfusion, cold static storage, and different perfusate options 23–25 . These studies utilized machine perfusion as a model for liver reperfusion after preservation and ICG as a measure of liver function.…”

“…8 In animal studies involving rats and pigs, ICG clearance has been used to assess the performance of hypothermic machine perfusion, cold static storage, and different perfusate options. [23][24][25] These studies utilized machine perfusion as a model for liver reperfusion after preservation and ICG as a measure of liver function. Universally, ICG clearance correlated with conventional markers of liver function in a pig model and could distinguish between livers preserved with different perfusates and at different temperatures.…”

“…Universally, ICG clearance correlated with conventional markers of liver function in a pig model and could distinguish between livers preserved with different perfusates and at different temperatures. [23][24][25] In the current F I G U R E 2 ICG clearance assessment. A single dose of 7.5 mg of ICG was administered on days 0 (A), 1 (B), and 4 (C).…”

Development of an automated liver perfusion system: The benefit of a hemofilter

“…According to the current technology, to date, the use of centrifugal or pulsatile pumps is still under debate. The use of roller pumps by groups such as Bruinsma et al, 11 Monbaliu's et al, 12 and Brockbank's et al 13 is not a problem, if and only if, the perfusion liquid is an acellular solution. However, in the case of complete blood, centrifugal pumps seem to be a better option as the experience with extracorporeal membrane oxygenation (ECMO) circuits shows in clinical practice.…”