Oxygen consumption during hypothermic and subnormothermic machine perfusions of porcine liver grafts after cardiac death

Morito, Noriyuki; Obara, Hiromichi; Matsuno, Naoto; Enosawa, Shin; Furukawa, Hiroyuki

doi:10.1007/s10047-018-1063-0

Cited by 13 publications

(14 citation statements)

References 26 publications

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“…Oxygenated SNMP improves not only the oxygen uptake but also the adenosine triphosphate content and reduces the lactate levels of the donor liver [13,14]. Our previous study showed that the oxygen consumption was related to the graft temperature and associated with the effluent LDH level [23]. However, hypothermic conditions seem to have limited utility in graft preservation.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2019

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The recent clinical application of perfusion technology for the machine preservation of donation after cardiac death (DCD) grafts has some advantages. Oxygenation has been proposed for the preservation of DCD liver grafts. The aim of this study is to clarify whether the use of HbV-containing preservation solution during the subnormothermic machine perfusion (SNMP) of the liver graft improves the graft function of DCD porcine livers in an ex vivo reperfusion model. Pig livers were excised after 60 minutes of warm ischemic time and were preserved under one of three preservation conditions for 4 hours. The preservation conditions were as follows: 4°C cold storage (CS group; N = 5), Hypothermic machine preservation (HMP) with UW gluconate solution (HMP group; N = 5), SNMP (21°C) with UW gluconate solution (SNMP group; N = 5), SNMP (21°C) with HbVs (Hb; 1.8 mg/dl) perfusate (SNMP+HbV group; N = 5). Autologous blood perfusion was performed for 2 hours in an isolated liver reperfusion model (IRM). The oxygen consumption of the SNMP and SNMP+HbV group was higher than the HMP groups (p < 0.05). During the reperfusion, the AST level in the SNMP+HbV group was lower than that in the CS, HMP and SNMP groups. The changes in pH after reperfusion was significantly lower in SNMP+HbV group than CS and HMP groups. The ultrastructural findings indicated that the mitochondria of the SNMP+HbV group was well maintained in comparison to the CS, HMP and SNMP groups. The SNMP+HbVs preservation solution protected against metabolic acidosis and preserved the liver function after reperfusion injury in the DCD liver.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2019

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“…However, the benefits of this combination on tissue lesions in the late phase suggest that an intermediate oxygenation level could be more efficient. Perfusion supplementation with M101 and O 2 could also be valuable in other conditions, such as a sub-normothermic situation, which has been reported as being better than hypothermic perfusion in terms of organ preservation quality, as suggested by Morito et al [31]. Finally, these findings are potentially applicable to other organs, such as liver, for which MP techniques are just emerging.…”

Section: Discussionmentioning

confidence: 76%

Individual and Combined Impact of Oxygen and Oxygen Transporter Supplementation during Kidney Machine Preservation in a Porcine Preclinical Kidney Transplantation Model

Kasil

Giraud

Couturier

et al. 2019

IJMS

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Marginal kidney graft preservation in machine perfusion (MP) is well-established. However, this method requires improvement in order to mitigate oxidative stress during ischemia-reperfusion, by using oxygenation or an O2 carrier with anti-oxidant capacities (hemoglobin of the marine worm; M101). In our preclinical porcine (pig related) model, kidneys were submitted to 1h-warm ischemia, followed by 23 h hypothermic preservation in Waves® MP before auto-transplantation. Four groups were studied: W (MP without 100%-O2), W-O2 (MP with 100%-O2; also called hyperoxia), W-M101 (MP without 100%-O2 + M101 2 g/L), W-O2 + M101 (MP with 100%-O2 + M101 2 g/L) (n = 6/group). Results: Kidneys preserved in the W-M101 group showed lower resistance, compared to our W group. During the first week post-transplantation, W-O2 and W-M101 groups showed a lower blood creatinine and better glomerular filtration rate. KIM-1 and IL-18 blood levels were lower in the W-M101 group, while blood levels of AST and NGAL were lower in groups with 100% O2. Three months after transplantation, fractional excretion of sodium and the proteinuria/creatinuria ratio remained higher in the W group, creatininemia was lower in the W-M101 group, and kidney fibrosis was lower in M101 groups. We concluded that supplementation with M101 associated with or without 100% O2 improved the Waves® MP effect upon kidney recovery and late graft outcome.

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“…In our system, each hepatic artery (HA) and portal vein (PV) was perfused. Details of our system are reported in previous papers [9,10]. Each circuit consisted of a roller-type pump (MasterFlex7520-40; Cole-Parmer, Bunker Court, IL, USA), an electrical flow meter (VN05; Aichi Tokei, Aichi, Japan for PV; FD-SS02; Keyence, Osaka, Japan for HA), a ceramic capacitive pressure sensor (KL76; Nagano Keiki, Nagano, Japan), and an air trap developed in-house.…”

Section: Machine Perfusion Systemmentioning

confidence: 99%

“…Each circuit consisted of a roller-type pump (MasterFlex7520-40; Cole-Parmer, Bunker Court, IL, USA), an electrical flow meter (VN05; Aichi Tokei, Aichi, Japan for PV; FD-SS02; Keyence, Osaka, Japan for HA), a ceramic capacitive pressure sensor (KL76; Nagano Keiki, Nagano, Japan), and an air trap developed in-house. An oxygenator (HP0-06 H-C; Senko Medical Instrument, Tokyo, Japan) was installed in the circuit for the PV and HA [10]. The flow rate of the PV was 0.22 mL/min/g and that of the HA was 0.06 mL/min/g.…”

Section: Machine Perfusion Systemmentioning

confidence: 99%

“…We maintained the condition of the oxygen concentration to hold the minimum dissolved oxygen concentration for the calculation of the oxygen consumption at the outlet port. We calculated the oxygen consumption (mg/min/100 g liver) of the organ as normalized values with the mass of the organ (mg/min/100 g liver) from the difference in the oxygen concentration at the inlet port of the PV circuit and the outlet port positioned near the hepatic vein [10].…”

Section: Oxygenationmentioning

confidence: 99%

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Applicability of Hypothermic Oxygenate Machine Perfusion Preservation for Split-Liver Transplantation in a Porcine Model: An Experimental Study

et al. 2020

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Background: Split-liver transplantation can be useful in situations of limited donor resources. However, novel preservation methods are required to help the recipient recover from severe ischemic reperfusion injury incurred due to receiving a relatively small liver graft. Material/Methods: Our experiment was performed using porcine livers without warm ischemia time, assuming a brain-dead organ. We made porcine split-liver grafts by 75% liver resection at the back table and divided the specimens into 4 groups. Group 1 was preserved with simple cold storage after splitting (CS; n=3), Group 2 was preserved with hypothermic perfusion preservation (HMP) after splitting (SBP; n=3), Group 3 was preserved with HMP after splitting under perfusion preservation (SDP; n=4), and Group 4 had the whole liver perfused as control grafts (Whole Liver; n=3). To assess potential methods of preservation and their effects, all grafts were evaluated by an ex vivo isolated liver reperfusion model using diluted autologous blood. Results: Portal vein pressure resistances during reperfusion were low in Group3 (SDP). Hepatic artery pressure resistances during reperfusion were markedly higher in Group 1(CS) than in the other groups. The levels of AST and LDH were high and increased at 2 h after reperfusion in Group 1 (CS). The histological findings show that the liver cell structure was irregular in Group 1 (CS) but remained regular in Groups 2 (SBP) and 3 (SDP). Histological Suzuki scores were also significantly better in Groups 2 (SBP) and 3 (SDP) compared with Group 1 (CS). Conclusions: Splitting the liver under machine perfusion preservation may help restore the function and reduce ischemiareperfusion injury.

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Oxygen consumption during hypothermic and subnormothermic machine perfusions of porcine liver grafts after cardiac death

Cited by 13 publications

References 26 publications

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

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

Individual and Combined Impact of Oxygen and Oxygen Transporter Supplementation during Kidney Machine Preservation in a Porcine Preclinical Kidney Transplantation Model

Applicability of Hypothermic Oxygenate Machine Perfusion Preservation for Split-Liver Transplantation in a Porcine Model: An Experimental Study

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