Details

Autor(en) / Beteiligte

• Brüggenwirth, Isabel M. A.
• Plas, Willemijn S.
• Leeuwen, Otto B.
• Thorne, Adam M.
• Rayar, Michel
• Meijer, Vincent E.
• Porte, Robert J.

Titel

Oxygenated versus non‐oxygenated flush out and storage of donor livers: An experimental study

Ist Teil von

• Artificial organs, 2022-02, Vol.46 (2), p.201-209

Ort / Verlag

United States: Wiley Subscription Services, Inc

Erscheinungsjahr

2022

Quelle

Wiley Online Library - AutoHoldings Journals

Beschreibungen/Notizen

• Background During donor organ procurement and subsequent static cold storage (SCS), hepatic adenosine triphosphate (ATP) levels are progressively depleted, which contributes to ischemia‐reperfusion injury (IRI). We sought to investigate a simple approach to prevent ATP depletion and IRI using a porcine donation after circulatory death (DCD) liver reperfusion model. Methods After 30 min warm ischemia, porcine livers were flushed via the portal vein with cold (4°C) non‐oxygenated University of Wisconsin (UW) preservation solution (n = 6, control group) or with oxygenated UW (n = 6, OxyFlush group). Livers were then subjected to 4 h SCS in non‐oxygenated (control) or oxygenated (OxyFlush) UW, followed by 4 h normothermic reperfusion using whole blood. Hepatic ATP levels were compared, and hepatobiliary function and injury were assessed. Results At the end of SCS, ATP was higher in the OxyFlush group compared to controls (delta ATP of +0.26 vs. −0.68 µmol/g protein, p = 0.04). All livers produced bile and metabolized lactate, and there were no differences between the groups. Grafts in the OxyFlush group had lower blood glucose levels after reperfusion (p = 0.04). Biliary pH, glucose and bicarbonate were not different between the groups. Injury markers including liver transaminases, lactate dehydrogenase, malondialdehyde, cell‐free DNA and flavin mononucleotide in the SCS solution and during reperfusion were also similar. Histological assessment of the parenchyma and bile ducts did not reveal differences between the groups. Conclusion Oxygenated flush out and storage of DCD porcine livers prevents ATP depletion during ischemia, but this does not seem sufficient to mitigate early signs of IRI. In this study, donation after circulatory death livers flushed with and stored in an oxygenated cold preservation solution were compared to non‐oxygenated controls. At the end of static cold storage, ATP levels were higher in the oxygenated group, but this was not sufficient to mitigate ischemia‐reperfusion injury after reperfusion. ATP, adenosine triphosphate; DCD, donation after circulatory death; SCS, static cold storage.