Details

Autor(en) / Beteiligte

• Panayotova, Guergana G.
• Rosado, Jesus
• Paterno, Flavio
• Deo, Dayanand
• Dikdan, George
• McCarty, Matthew A.
• Arrington, Ben
• Giudice, Anthony
• Fano, Adam
• Dhaduk, Nehal
• Lunsford, Keri E.
• Rao, Prakash
• Guarrera, James V.

Titel

Novel oxygenation technique for hypothermic machine perfusion of liver grafts: Validation in porcine Donation after Cardiac Death (DCD) liver model

Ist Teil von

• The American journal of surgery, 2020-11, Vol.220 (5), p.1270-1277

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2020

Quelle

MEDLINE

Beschreibungen/Notizen

• Hypothermic oxygenated machine perfusion improves outcomes in Liver Transplantation, but application is limited as O2 is supplied by a stationary circuit. A novel technique of O2 “pre-charge” in a portable pump would broaden use and further mitigate ischemia damage from organ transport. Porcine DCD livers were randomized to static cold storage (SCS, n = 8) or hypothermic machine perfusion (HMP). HMP was stratified into HMP-O2 (n = 5), non-O2 open to air HMP-RA (n = 5), and non-O2 with sealed lids or no air HMP-NA (n = 5). HMP-O2 was “pre-charged” using 100% O2 delivered at 10 L/min over 15 min. Perfusate and tissue O2 tension (pO2), liver biopsies, and fluid chemistries were analyzed. “Pre-charge” achieves sustained tissue and perfusate pO2 vs others. HMP-O2 results in decreased markers of hepatocyte injury: ALT (p < 0.05) and LDH (p < 0.05), lower expression of CRP and higher expression of SOD1 vs SCS. This suggests decreased inflammation and improved ROS scavenging. “Pre-charge” is an effective technique, which allows portability and transport without an O2 source and improves graft parameters. •Oxygen “pre-charge” by 100% O2 for 15 min achieves high, persistent oxygen levels for perfusion.•HMP treatment leads to significant decrease in markers of injury: ALT and sCD-146.•Pre-charged HMP-O2 results in improved aerobic metabolism: decreased LDH.•HMP results in downregulation of CRP expression, a nonspecific marker of inflammation.•HMP results in upregulation of SOD1 expression, an ROS scavenger.