Liver Transplantation from Non-Heart-Beating Donors: Current Status and Future Prospects in an Experimental Model

Monbaliu, Diethard; Vekemans, Katrien; Liu, Qiang; Heedfeld, Veerle; Wylin, Tine; Breussegem, A Van; Pirenne, Jacques

doi:10.1080/00015458.2008.11680174

Cited by 6 publications

(7 citation statements)

References 1 publication

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“…Nevertheless, both systems of preservation for livers could be suitable for application in different circumstances to get better use of livers from non-heart-beating donors to increase the pool of available organs. The hypothermic perfusion system for preserving livers prior to transplantation represents an alternative strategy for diminishing injury due to warm ischemia in NHBDs.Also, the possibility of applying pharmacological measures during this procedure could open up other possibilities, like the addition of bioactive gases (NO, SH2 or CO) (26). Notwithstanding the fact that normothermic reperfusion is a good in vitro model for evaluating the outcome of preservation, preclinical hepatic transplantation is necessary for better understanding and evaluation of the entire process.…”

Section: Resultsmentioning

confidence: 99%

Hypothermic Machine Perfusion Versus Cold Storage in the Rescuing of Livers From Non‐Heart‐Beating Donor Rats

et al. 2013

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The aim of this work was to compare the efficiency of cold storage (CS) and hypothermic machine perfusion (HMP) methods of preserving grafts excised from non-heart-beating donors that had suffered 45 minutes of warm ischemia. We developed a new solution for HMP to use in liver transplantation, based on BES, gluconate, and polyethylene glycol (BGP-HMP solution). After 24 h of HMP or CS, livers were reperfused at 37°C with Krebs-Henseleit solution with added dextran. For both procedures, portal pressure and flow were measured and the intrahepatic resistance (IR) was calculated. The pH oscillations and enzyme activities (LDH, AST, and ALT) were evaluated for the perfusion buffer during normothermic reperfusion. O2 consumption of the liver, glycogen production, and bile flow were also measured during the normothermic reperfusion period. Portal flow and IR showed statistical differences (P < 0.05) between the two groups (n = 5). HMP with BGP-HMP solution resulted in higher values of portal flow and lower IR than CS with HTK solution. Enzyme release after 90 min of reperfusion did not show statistical differences between groups. With regard to bile flow and O2 consumption, livers preserved by both processes were able to produce bile, but livers preserved with HMP were able to take up more O2 than livers preserved by CS.

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Section: Resultsmentioning

confidence: 99%

Hypothermic Machine Perfusion Versus Cold Storage in the Rescuing of Livers From Non‐Heart‐Beating Donor Rats

et al. 2013

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“…The technical performances of prototype machines such as the Groningen Liver Perfusion System (Netherlands) and the Organ Recovery Systems device were tested using porcine livers [113;114;175;176]. Attention was given mainly to perfusion uniformity and cellular injury generation, hypothermia and flow regime maintenance, and consistency in oxygen supply during 24h continuous preservation.…”

Section: Hmp Of Other Transplant Organs (Heart Liver and Pancreas)mentioning

confidence: 99%

“…Monbaliu’s group in Belgium has also reported recently on studies using a prototype machine (Organ Recovery Systems,) in which porcine livers were hypothermically perfused for 24h with Belzer-MPS at 4–6°C [113;114]. Pressure controlled continuous perfusion through both the hepatic artery (<25mmHg) and portal vein (<7mmHg) was applied.…”

Section: Hmp Of Other Transplant Organs (Heart Liver and Pancreas)mentioning

confidence: 99%

Current state of hypothermic machine perfusion preservation of organs: The clinical perspective

2010

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This review focuses on the application of hypothermic perfusion technology as a topic of current interest with the potential to have a salutary impact on the mounting clinical challenges to improve the quantity and quality of donor organs and the outcome of transplantation. The ex vivo perfusion of donor organs on a machine prior to transplant, as opposed to static cold storage on ice, is not a new idea but is being re-visited because of the prospects of making available more and better organs for transplantation. The rationale for pursuing perfusion technology will be discussed in relation to emerging data on clinical outcomes and economic benefits for kidney transplantation. Reference will also be made to on-going research using other organs with special emphasis on the pancreas for both segmental pancreas and isolated islet transplantation. Anticipated and emerging benefits of hypothermic machine perfusion of organs are: i) maintaining the patency of the vascular bed, ii) providing nutrients and low demand oxygen to support reduced energy demands, iii) removal of metabolic by-products and toxins, iv) provision of access for administration of cytoprotective agents and/or immunomodulatory drugs, v) increase of available assays for organ viability assessment and tissue matching, vi) facilitation of a change from emergency to elective scheduled surgery with reduced costs and improved outcomes, vii) improved clinical outcomes as demonstrated by reduced PNF and DGF parameters, viii) improved stabilization or rescue of ECD kidneys or organs from NHBD that increase the size of the donor pool, ix) significant economic benefit for the transplant centers and reduced health care costs, and x) provision of a technology for ex vivo use of non-transplanted human organs for pharmaceutical development research.

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“…Since then, some HMPs have been developed, such as the LifeCradle TM HR system [17] for heart organs, the Groningen Machine Perfusion [18] for liver organs, the LifePort system [19] for kidney and pancreas organs.…”

Section: Primary Design Strategy and Materialsmentioning

confidence: 99%

Design and Implementation of a Hypothermic Machine Perfusion Device for Clinical Preservation of Isolated Organs

Shen

Yan

2017

Sensors

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The imbalance between limited organ supply and huge potential need has hindered the development of organ-graft techniques. In this paper a low-cost hypothermic machine perfusion (HMP) device is designed and implemented to maintain suitable preservation surroundings and extend the survival life of isolated organs. Four necessary elements (the machine perfusion, the physiological parameter monitoring, the thermostatic control and the oxygenation apparatus) involved in this HMP device are introduced. Especially during the thermostatic control process, a modified Bayes estimation, which introduces the concept of improvement factor, is realized to recognize and reduce the possible measurement errors resulting from sensor faults and noise interference. Also, a fuzzy-PID controller contributes to improve the accuracy and reduces the computational load using the DSP. Our experiments indicate that the reliability of the instrument meets the design requirements, thus being appealing for potential clinical preservation applications.

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Liver Transplantation from Non-Heart-Beating Donors: Current Status and Future Prospects in an Experimental Model

Cited by 6 publications

References 1 publication

Hypothermic Machine Perfusion Versus Cold Storage in the Rescuing of Livers From Non‐Heart‐Beating Donor Rats

Hypothermic Machine Perfusion Versus Cold Storage in the Rescuing of Livers From Non‐Heart‐Beating Donor Rats

Current state of hypothermic machine perfusion preservation of organs: The clinical perspective

Design and Implementation of a Hypothermic Machine Perfusion Device for Clinical Preservation of Isolated Organs

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