A Basic Consideration for Porcine Liver Preservation Using a Novel Continuous Machine Perfusion Device

Abstract Introduction The aims of this study were to compare extracellular and intracellular-type University of Wisconsin (UW) solutions for liver grafts and to assess oxygenation in this perfusion system. Materials and Methods The organ preservation system consisted of 3 circulating systems for the...

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Published in:Transplantation proceedings 2012-05, Vol.44 (4), p.942-945
Main Authors: Shigeta, T, Matsuno, N, Huai-Che, H, Obara, H, Mizunuma, H, Hirano, T, Uemoto, S, Enosawa, S
Format: Article
Language:English
Subjects:
Adenosine - administration & dosage
Allopurinol - administration & dosage
Animals
Aspartate Aminotransferases - metabolism
Biological and medical sciences
Cold Temperature
Equipment Design
Fundamental and applied biological sciences. Psychology
Fundamental immunology
Gluconates - administration & dosage
Glutathione - administration & dosage
Hepatic Artery - surgery
Insulin - administration & dosage
L-Lactate Dehydrogenase - metabolism
Liver - blood supply
Liver - enzymology
Liver - pathology
Liver - surgery
Liver Transplantation
Medical sciences
Necrosis
Organ Preservation - instrumentation
Organ Preservation Solutions - administration & dosage
Oxygen - administration & dosage
Perfusion - instrumentation
Portal Vein - surgery
Raffinose - administration & dosage
Surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Sus scrofa
Time Factors
Tissue, organ and graft immunology
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Summary:Abstract Introduction The aims of this study were to compare extracellular and intracellular-type University of Wisconsin (UW) solutions for liver grafts and to assess oxygenation in this perfusion system. Materials and Methods The organ preservation system consisted of 3 circulating systems for the portal vein, hepatic artery, and maintenance of the perfusion solution. The portal vein or hepatic artery system had a roller pump, a flow meter, and a pressure sensor. In this study, we perfused livers with UW or extracellular type UW-gluconate at 4°C–6°C for 4 hours. The flow rates at the entrance were 0.5 mL/min/g liver in the portal vein and 0.2 mL/min/liver in the hepatic artery. Orthotopic liver transplantation was performed in pigs: group 1-a, grafts procured after acute hemorrhagic shock were preserved by a solution without O2 ; group 1-b, grafts were preserved with O2 ; group 2-a, grafts were perfused using intracellular type solution (UW); and group 2-b, grafts were perfused using extracellular-type solution (UW-gluconate). Results Effluent aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) levels in group 1-b were lower than those in group 1-a. Survival rates in group 2-a and group 2-b were 1/4 and 3/3, respectively. Effluent AST and LDH levels in the perfusate of group 2-b were lower than group 2-a. Histological study revealed necrosis of hepatocytes and sinusoidal congestion in group 2-a. Conclusion A beneficial effect of extracellular-type solution with oxygenation in a novel continuous machine preservation system yielded well-preserved liver graft function.
ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2012.03.013