Effects of Short-Term Normothermic and Subnormothermic Perfusion After Cold Preservation on Liver Transplantation From Donors After Cardiac Death.

Abstract

BACKGROUND:

Liver transplantation from donors after cardiac death (DCD) could increase the pool of organs. We previously reported that oxygenated subnormothermic (20°C-25°C) ex vivo liver perfusion (SELP) improved the graft viability in rats. This study aimed to compare the effectiveness of SELP and normothermic (37°C) ex vivo liver perfusion (NELP) after cold storage (CS) in DCD liver grafts.

METHODS:

Male Wistar rats were used, and grafts were retrieved 30 minutes after cardiac arrest. We performed oxygenated NELP and SELP with a Krebs-Henseleit buffer for different time points and durations: Group 0, donation performed from heart-beating donors (control); Group 1 (DCD group), donation performed from DCD donors with no treatments; Group 2, NELP performed before CS (30 minutes); Group 3, NELP performed after CS (30 minutes); Group 4, SELP performed after CS (30 minutes); Group 5, SELP performed after CS (60 minutes); and Group 6, SELP performed after CS (90 minutes). After 15 minutes of incubation at room temperature, the grafts were reperfused under normothermic conditions for 60 minutes as a model of liver transplantation.

RESULTS:

No significant differences in body and liver weight were observed between all groups. In the SELP after CS groups, even 30 minutes of perfusion improved bile production, tumor necrosis factor-α, and interleukin-1β significantly compared with the DCD group (P < .05), comparable with NELP groups.

CONCLUSION:

SELP rescued DCD livers from ischemia-reperfusion injury the same as the normothermic perfusion before or after CS groups. SELP after CS is more convenient than normothermic perfusion; hence, this technique may increase the organ pool.

• Authors: Shuhei Yamada, Shigehito Miyagi, Yasuyuki Hara, Yuta Kakizaki, Hideaki Sasajima, Kazuhiro Mitsui, Keisei Fujimori, Michiaki Unno, Takashi Kamei, Masafumi Goto
• Journal: Transplantation proceedings (Transplant Proc) 2020 Jul - Aug Vol. 52 Issue 6 Pg. 1639-1642 ISSN: 1873-2623 [Electronic] United States
• PMID: 32471629 (Publication Type: Journal Article)
• Copyright: Copyright © 2020 Elsevier Inc. All rights reserved.

Topics

• Animals
• Cryopreservation
• Liver
• Liver Transplantation (methods)
• Male
• Perfusion (methods)
• Rats
• Rats, Wistar