Rat Liver Preservation by Hypothermic Oscillating Liver Perfusion Compared to Simple Cold Storage

Dutkowski, Philipp; Schönfeld, S.; Odermatt, Benjamin; Heinrich, Theresa; Junginger, T

doi:10.1006/cryo.1997.2066

Cited by 38 publications

(31 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In contrast to previously reported data, that indicated that long-term liver perfusion at hypothermia was easily possible without the addition of colloid to the perfusion medium [16,22], we found that vascular resistance of the damaged kidneys used in this study allowed for flow values of only approximately 0.2-0.3 ml/g/min if perfusion pressure was to be limited to 40 mmHg for longer periods of time. Hence, the IRR of about 1.26 mmHg g min/ml that we observed seems approximately twice as high as that seen under comparable conditions with the colloid containing Belzer MPS, the latter being in line with data calculated from colloid-enriched perfusion of kidneys as reported previously [lo, 231.…”

Section: Discussioncontrasting

confidence: 99%

Kidney transplantation from non-heart-beating donors after oxygenated low-flow machine per fusion preservation with histidine-tryptophan-ketoglutarate solution

2004

View full text Add to dashboard Cite

The aim of this study was to determine the potential benefit of aerobic machine preservation (MP) with non-colloidal histidine-tryptophan-ketoglutarate (HTK) solution compared with MP with Belzer machine perfusion solution (MPS) and standard cold storage, after marginal kidneys had been obtained from non-heart-beating donors. Cardiac arrest was electrically induced in anaesthetized German landrace pigs (20-25 kg bw). Their kidneys were harvested 40 min thereafter, flushed with HTK by gravity of 100 cm H20 via the renal artery and then stored in HTK for 18 h at 4°C. Other organs were subjected to oxygenated (p02 > 500 mmHg) hypothermic pulsatile low-flow machine perfusion with HTK or MP with Belzer MPS at P,,,=40 mmHg, yielding transrenal flow values of 0.2-0.3 ml/min per g with HTK and approximately twice that amount with Belzer MPS. A well-preserved vascular endothelium and intact tubular epithelium were documented by electron microscopy at the end of perfusion preservation in both solutions as well as after cold storage. Concentrations of ATP (in micromoles per gramme) in tissue homogenates at the end of perfusion preservation with HTK were 1.18f0.12 vs 0.16 i 0.02 (P < 0.05) after simple cold storage and 2.43 f 0.23 after perfusion with Belzer MPS, thus documenting a relevant effect of low-flow perfusion on tissue oxygenation. Viability of the grafts was followed for 1 week after heterotopic transplantation and bilateral nephrectomy in the recipient pigs. Machine perfusion with HTK significantly improved cortical microcirculation upon early reperfusion in vivo, as well as maximal serum levels of urea and creatinine, compared to recipients receiving cold-stored grafts. No differences could be found between MP with HTK or Belzer MPS. In conclusion, provision of oxygen during storage is possible by low-flow perfusion with HTK as with Belzer MPS and apparently improves graft viability after transplan tation.

show abstract

Section: Discussioncontrasting

confidence: 99%

Kidney transplantation from non-heart-beating donors after oxygenated low-flow machine per fusion preservation with histidine-tryptophan-ketoglutarate solution

2004

View full text Add to dashboard Cite

show abstract

“…As any static cold storage leads to anaerobic metabolism within short time, because of the lack of oxygen and substrates [15], machine perfusion has traditionally been designed as a continuous approach, starting directly after organ procurement. In the past 10 years, it became, however, clear that instead of continuous cold perfusion upfront, endischemic perfusion after cold storage is an attractive option [16][17][18][19].…”

Section: Upfront Vs Endischemic Perfusionmentioning

confidence: 99%

“…This effect relates to a decrease of electron-rich substrates during hypothermic oxygenation [22]. HOPE may, therefore, provides a reversible downregulation of mitochondrial chain carriers, which leads to slow 'switching on' of mitochondrial electron transfer during normothermic reperfusion [15,22].…”

Section: Oxygenmentioning

confidence: 99%

Hypothermic machine perfusion in liver transplantation

Schlegel

Kron

Dutkowski

2016

Current Opinion in Organ Transplantation

View full text Add to dashboard Cite

Purpose of the reviewThe purpose of the review is to report recent human application of hypothermic machine liver perfusion, and to discuss potential protective mechanisms. Recent findingsHuman application of hypothermic machine liver perfusion is still very limited. Currently, three transplant centers apply this novel treatment in donation after cardiac death (DCD) or donation after brain death (DBD) liver grafts. In all cases, endischemic perfusion was performed after initial cold storage for organ transport. Perfusion conditions differ slightly in terms of oxygenation (pO 2 15-60 kPa), perfusion route (dual vs. portal), perfusion time (2-4 h), and perfusate. SummaryThe current data support the hypothesis that applying endischemic hypothermic machine liver perfusion protects extended criteria DBD and DCD livers from initial reperfusion injury, with better graft function and less biliary complications. Hypothermic machine perfusion may therefore offer revitalization of liver grafts before implantation by a simple and practical perfusion technique with a high impact on enlarging the donor pool. Multicentric phase III randomized control trials in DBD and DCD liver transplantation have been initiated to further test this strategy, which may establish machine liver perfusion in the clinical setting.

show abstract

“…The animals were anesthetized with ether and the liver was exposed through a midline incision. The liver was cannulated, flushed and resected as previously described (6,11).…”

Section: Animalsmentioning

confidence: 99%

“…Glykolytic metabolites: Liver glycogen, ATP, ADP, AMP, energy charge and lactate were determined according to earlier studies (6,11): for analysis of nucleotides livers were homogenated (1:10) in cold 4% HClO 4 with a Potter teflon homogenizer. After centrifugation and pH adjusting (pH 8.5) ATP was measured by UV spectroscopy (340 nm) with hexokinase and glucose-6-phosphate dehydrogenase.…”

Section: Assessment Of Hepatocyte Cell Injurymentioning

confidence: 99%

Rescue of the Cold Preserved Rat Liver by Hypothermic Oxygenated Machine Perfusion

Dutkowski

Graf

Clavien

2006

American Journal of Transplantation

Self Cite

106

View full text Add to dashboard Cite

The aim of the study was to investigate whether hypothermic oxygenated liver perfusion after cold liver preservation resuscitated metabolic parameters and whether this treatment had a benefit for liver viability upon reperfusion.We preserved rat livers either by cold storage (UW) for 10 h, or by perfusion for 3 h (oxygenated modified UW) after 10 h cold storage. We assessed viability of livers after preservation and after ischemic rewarming + normothermic reperfusion ex vivo. Ten hour cold storage reduced mitochondrial cytochrome oxidase and metabolically depleted the livers. Oxygenated perfusion after cold storage resulted in uploaded cellular energy charge and oxidized mitochondrial cytochrome oxidase. Reperfusion after 10 h cold storage increased formation of superoxid anions, release of cytosolic LDH, lipid peroxidation, caspase activities and led to disruption of sinusoidal endothelial cells. In contrast, reperfusion after 10 h cold storage + 3 h hypothermic oxygenated perfusion resulted in no changes of lipid peroxidation, bile flow, energy charge, total glutathione, LDH release and of caspase activation, as compared to fresh resected livers. This study demonstrates, that a metabolically depleted liver due to cold storage can be energy recharged by short-termed cold machine perfusion. The machine perfused graft exhibited improved viability and functional integrity.

show abstract

Rat Liver Preservation by Hypothermic Oscillating Liver Perfusion Compared to Simple Cold Storage

Cited by 38 publications

References 23 publications

Kidney transplantation from non-heart-beating donors after oxygenated low-flow machine per fusion preservation with histidine-tryptophan-ketoglutarate solution

Kidney transplantation from non-heart-beating donors after oxygenated low-flow machine per fusion preservation with histidine-tryptophan-ketoglutarate solution

Hypothermic machine perfusion in liver transplantation

Rescue of the Cold Preserved Rat Liver by Hypothermic Oxygenated Machine Perfusion

Contact Info

Product

Resources

About