Successful ex Vivo Normothermic Liver Perfusion with Purely Artificial Products using Artificial Blood

Abstract

We tried to make an ex vivo functioning liver with an artificial perfusate that consisted of artificial blood in the pig liver. A liver graft from a female pig weighing 20 kg was harvested in the usual manner. The perfusion solution consisted of artificial blood, L-15 medium, distilled water, bovine serum albumin, NaHCO3, NaOH, KCl, human regular insulin, 50% glucose solution, and dexamethasone. The isolated liver was perfused with this oxygenated perfusate through the portal vein at a rate of 300 ml/min for 9 hours. Seven livers were perfused for 9 hours in this system. Five of the livers showed mean oxygen consumption of over 8 ml-02/min during perfusion. Histological findings showed that the hepatic architecture was almost completely preserved and numerous hepatocytes exhibited PAS-positive cytoplasmic glycogen deposits in these livers. These observations indicate that we have succeeded in developing an ex vivo functioning liver with an artificial perfusate employing artificial blood.

The Functional Integrity of a Normothermic Perfusion System Using Artificial Blood in Pig Liver

“…The lactate level of the perfusate was relatively low in the high oxygen livers compared with low oxygen livers. Among the seven livers, two had low oxygen consumption and could not be preserved well [8]. Although the reason for this is unknown, we considered that some livers were not suitable for these artificial systems or that these livers were perhaps primary nonfunction livers due to some problems in our harvesting method.…”

“…However, these were not true artificial perfusion systems because their perfusates used organ blood as the oxygen carrier. We have already reported that we succeeded in developing a normothermic liver perfusion system using purely artificial products as a perfusion solution for the first time in the world [8]. In this system, the perfused liver exhibited cytoplasmic glycogen deposits in numerous cells and had a relatively low lactate level in the perfusate; accordingly, we could ascertain that the perfused liver function was preserved in this system.…”