Liver Transplantation After Organ Preservation With Normothermic Extracorporeal Perfusion

Schön, Michael P.; Kollmar, Otto; Wolf, S.; Schrem, Harald; Matthes, M; Akkoç, Nefise; Schnoy, N.; Neuhaus, P.

doi:10.1097/00000658-200101000-00017

Cited by 246 publications

(186 citation statements)

References 36 publications

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“…This study supports the applicability of the proposed protocol by Morais et al 13 This method has no pharmacological drugs interference, which could compromise graft function by influencing the Na/K transport between membranes, neither the precocious effects of ischemia-reperfusion injury provided by exsanguination described by Schön et al 15 , nor the imprecise analysis of variables and outcomes in the model proposed by Sato et al 16 , once the latter is absent of specification of electrocardiographic criteria and points high variability of time between the withdrawal of life support and cardiac arrest 15,16 . Since no pharmacologic agents or life support withdraw were used in our study with the intent of cardiac arrest, we speculate that organ preservation can be achieved with minimal experimental bias.…”

Section: Discussionsupporting

confidence: 86%

The feasibility of an experimental model of donors after cardiac death in remote ischemic preconditioning studies for renal transplantation in porcine

Camarço

Morais²,

Moreno³

et al. 2014

Acta Cir. Bras.

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PURPOSE:To evaluate the feasibility of an experimental model of donors after cardiac death in remote ischemic preconditioning studies. METHODS:Twelve Landrace pigs were used as organ donors. They underwent cardiac arrest by coronary en block suture and interruption of ventilatory support. Haemodynamic data regarding the donor surgical protocol were evaluated. Studies variables included mean heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, central venous pressure and oxygen saturation and the time to death. RESULTS:Haemodynamic parameter indicated that the circulatory failure occurred after nine minutes of en block coronary suture and respiratory support interruption. The circulatory collapse occurred evenly across all groups. The heart rate and central venous pressure were statistically different between groups (p=0.023 and p=0.04), respectively. The remote preconditioning resulted in delayed time of death. CONCLUSIONS:The model is feasible, and was easily reproduced. The ischemic remote preconditioning tends to a slight increase in circulatory failure time.

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Section: Discussionsupporting

confidence: 86%

The feasibility of an experimental model of donors after cardiac death in remote ischemic preconditioning studies for renal transplantation in porcine

Camarço

Morais²,

Moreno³

et al. 2014

Acta Cir. Bras.

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show abstract

“…Schön et al 14 describe the exsanguination as a way to obtain the donor heart arrest. The induction of hypovolemic shock in this model directly interferes in the organ to be preserved, since hypovolemia worsens and begins the process of ischemia and reperfusion, making it difficult to validate the proposed results.…”

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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“…Results in porcine transplant models have shown NELP to be superior to cold perfusion via UW solution. 101 For NHBD, machine perfusion with the addition of pentoxifylline or arginine to perfusion solutions may also improve the quality of these grafts by reversing ischemic damage. 102,103 Hypernatremia was shown by the UCLA group to be one of five variables with prognostic value in predicting graft survival after transplantation.…”

Section: Experimental Strategies For the Manipulation Of Marginal Donorsmentioning

confidence: 99%

The utility of marginal donors in liver transplantation

Busuttil¹

2003

Liver Transplantation

629

508

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The shortage of organs has led centers to expand their criteria for the acceptance of marginal donors. The combination of multiple marginal factors seems to be additive on graft injury. In this review, the utility of various marginal donors in patients requiring liver transplantation will be described, including older donors, steatotic livers, non-heart-beating donors, donors with viral hepatitis, and donors with malignancies. The pathophysiology of the marginal donor will be discussed, along with strategies for minimizing the ischemia reperfusion injury experienced by these organs. Finally, new strategies for improving the function of the marginal/expanded donor liver will be reviewed. (Liver Transpl 2003;9:651-663.)

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Liver Transplantation After Organ Preservation With Normothermic Extracorporeal Perfusion

Abstract: The technique of NELP holds the potential to keep a mammalian liver outside the body completely functional, possibly for more than 4 hours. NELP can be used for liver preservation before transplantation or for the use of organs from non-heart-beating donors.

Cited by 246 publications

References 36 publications

The feasibility of an experimental model of donors after cardiac death in remote ischemic preconditioning studies for renal transplantation in porcine

The feasibility of an experimental model of donors after cardiac death in remote ischemic preconditioning studies for renal transplantation in porcine

Non heart beating organ donor: new experimental model in pigs

The utility of marginal donors in liver transplantation

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