Hepatic Blood Flow and Oxygen Extraction Ratio During Normothermic Recirculation and Total Body Cooling as Viability Predictors in Non-Heart-Beating Donor Pigs1

Valero, Ricard; Jc, García-Valdecasas; Tabet, J; Taurà, Pilar; Rull, R.; Beltrán, Joan; García, Félix; Fx, González; Ma, López-Boado; Cabrer, C; Visa, J

doi:10.1097/00007890-199807270-00005

Cited by 56 publications

(54 citation statements)

References 17 publications

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“…Takada et al 11 , Kamachi et al 12 and Valero et al 13 are groups that describe the model by administering a lethal dose of potassium chloride. However, there is significant interference to the mechanism of active transport across membranes by K + / Na +, promote cellular changes that can compromise organ preservation.…”

Section: Discussionmentioning

confidence: 99%

Non heart beating organ donor: new experimental model in pigs

Morais¹,

Júnior²,

Moreno

et al. 2012

Acta Cir. Bras.

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PURPOSE:To describe technical aspects of a new experimental model that simulates a non heart beating organ donor. METHODS:Landrace pigs were operated on and cardiac arrest was obtained by means of myocardial infarction and interruption of ventilator support. RESULTS:Mean cardiac frequency, systolic and diastolic blood pressure levels, central venous pressure, oxygen saturation and concentration of expired CO 2 dropout occurred at seven minutes after cardiac arrest. CONCLUSION:The procedure was easily reproduced and a homogeneous circulatory failure could de obtained by the end of seven minutes. The model is suitable for further studies regarding abdominal organ transplantation.Key words: Transplantation. Models, Animal. Experimental Development. Heart Arrest. Swine. RESUMO OBJETIVO:Descrever os aspectos técnicos de um novo modelo experimental que simula um doador de órgãos após a parada cardíaca. MÉTODOS:Suínos da raça Landrace foram operados e a parada cardíaca foi obtida por meio de infarto do miocárdio e interrupção do suporte ventilatório. RESULTADOS:Freqüência cardíaca, pressão arterial sistólica e diastólica, pressão venosa central, saturação de oxigênio e concentração parcial de CO 2 são consistentes com falência hemodinâmica ao final de sete minutos. CONCLUSÕES:O procedimento foi facilmente executado e uma falência circulatória pode ser obtida ao final de sete minutos. Este modelo é adequado para estudos posteriores com respeito a preservação e tranplantes de órgãos abdominais.

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Section: Discussionmentioning

confidence: 99%

Non heart beating organ donor: new experimental model in pigs

Morais¹,

Júnior²,

Moreno

et al. 2012

Acta Cir. Bras.

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“…Although some authors were not able to demonstrate any difference depending on the bypass temperature, 4 there is evidence based on experimental porcine models that supports the use of normothermic recirculation of oxygenated blood at 37°C. 21,22 According to Net et al, 23 NECMO could shift the warm ischemia time to an ischemic preconditioning period, providing greater viability to UNHBD livers.…”

Section: Discussionmentioning

confidence: 99%

Liver transplantation using uncontrolled non-heart-beating donors under normothermic extracorporeal membrane oxygenation

et al. 2009

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Because of the organ shortage, non-heart-beating donors have been proposed as a possible source of grafts for orthotopic liver transplantation (OLT). Despite the widespread use of controlled non-heart-beating donors, there are only a few published studies reporting the outcomes with uncontrolled non-heart-beating donors (UNHBDs). A prospective case-control study on adult patients undergoing OLT was designed. We used normothermic extracorporeal membrane oxygenation (NECMO) in all UNHBDs. Matching 2:1 ratio comparison was performed between a study group (UNHBDs) and a brain death donor (BDD) control group. Between January 2006 and March 2008, a total of 60 patients were included: 20 in the UNHBD group and 40 in the control group. The incidence of ischemic cholangiopathy was 5% (n ϭ 1) for the UNHBD group and 0% for the BDD group (P ϭ 0.15). The rate of primary nonfunction was 10% (n ϭ 2) in UNHBD recipients and 2.5% (n ϭ 1) in BDD recipients (P ϭ 0.21), with graft loss in all of them. Three patients were retransplanted in the UNHBD group (15%), 2 of them because of primary nonfunction and 1 because of ischemic cholangiopathy; no patient was retransplanted in the control group (P ϭ 0.012). After a mean follow-up of 330.4 Ϯ 224.9 days, 1-year cumulative patient survival was 85.5% for the UNHBD group and 87.5% for the BDD group (P ϭ 0.768). One-year cumulative graft survival was 80% in the UNHBD group and 87.5% in the BDD group (P ϭ 0.774). In conclusion, UNHBDs under NECMO are a potential source of organs for OLT with encouraging outcomes potentially comparable to those obtained with BDDs.

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“…65,66 The use of isolated perfusion to predict survival of steatotic livers before transplantation would merely require establishing parameters that correlate with survival. These may include hemodynamic parameters, 67 as well as markers of synthetic function 68 and liver injury 69 assessed by sampling perfusate. If a supply of oxygen and nutrients is provided within a suitable perfusate, then continual normothermic preservation may become a viable reality, thus abrogating the increased sensitivity of fatty livers to cold preservationreperfusion injury.…”

Section: Potential For Novel Preservation Methods and Amelioration Ofmentioning

confidence: 99%

Hepatic steatosis and its relationship to transplantation

Imber

Peter

Handa

et al. 2002

Liver Transplantation

150

108

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Hepatic Blood Flow and Oxygen Extraction Ratio During Normothermic Recirculation and Total Body Cooling as Viability Predictors in Non-Heart-Beating Donor Pigs1

Abstract: The use of a NR period before total body cooling improves survival of liver transplantation in NHBDs. Portal blood flow and pump blood flow measurements can predict the viability of the grafts.

Cited by 56 publications

References 17 publications

Non heart beating organ donor: new experimental model in pigs

Non heart beating organ donor: new experimental model in pigs

Liver transplantation using uncontrolled non-heart-beating donors under normothermic extracorporeal membrane oxygenation

Hepatic steatosis and its relationship to transplantation

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