Oxygenated versus non‐oxygenated flush out during deceased donor liver procurement: The first proof‐of‐concept study in humans

Abstract Background Liver transplantation is used for treating end‐stage liver disease, fulminant hepatitis, and oncological malignancies and organ shortage is a major limiting factor worldwide. The use of grafts based on extended donor criteria have become internationally accepted. Oxygenated machi...

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Published in:Artificial organs 2024-07
Main Authors: Fernandes, Eduardo de Souza Martins, Corrêa, Raphael Rodrigues, Furtado, Rodrigo Lopes Leite, Brüggenwirth, Isabel M. A., Yang, Cindy, de Mello, Felipe Pedreira Tavares, de Oliveira Andrade, Ronaldo, Pimentel, Leandro Moreira Savattone, Girão, Camila Liberato, César, Camilla, Siqueira, Munique Ana Pimentel, Braga, Eduardo Pinho, Carvalho, Angela Cristina Gouvea, Porte, Robert J., Bouskela, Eliete
Format: Article
Language:English
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Summary:Abstract Background Liver transplantation is used for treating end‐stage liver disease, fulminant hepatitis, and oncological malignancies and organ shortage is a major limiting factor worldwide. The use of grafts based on extended donor criteria have become internationally accepted. Oxygenated machine perfusion technologies are the most recent advances in organ transplantation; however, it is only applied after a period of cold ischemia. Due to its high cost, we aimed to use a novel device, OxyFlush®, based on oxygenation of the preservation solution, applied during liver procurement targeting the maintenance of ATP during static cold storage (SCS). Methods Twenty patients were randomly assigned to the OxyFlush or control group based on a 1:1 ratio. In the OxyFlush group, the perfusion solution was oxygenated with OxyFlush® device while the control group received a non‐oxygenated solution. Liver and the common bile duct (CBD) biopsies were obtained at three different time points. The first was at the beginning of the procedure, the second during organ preparation, and the third after total liver reperfusion. Biopsies were analyzed, and adenosine triphosphate (ATP) levels and histological scores of the liver parenchyma and CBD were assessed. Postoperative laboratory tests were performed. Results OxyFlush® was able to maintain ATP levels during SCS and improved the damage caused by the lack of oxygen in the CBD. However, OxyFlush® did not affect laboratory test results and histological findings of the parenchyma. Conclusion We present a novel low‐cost device that is feasible and could represent a valuable tool in organ preservation during SCS.
ISSN:0160-564X
1525-1594
1525-1594
DOI:10.1111/aor.14815