Sequential Cold Storage and Normothermic Perfusion of the Ischemic Rat Liver

Sequential Cold Storage and Normothermic Perfusion of the Ischemic Rat Liver

Abstract Extending transplant criteria to include livers obtained from donors after cardiac death (DCD) could increase the liver donor pool, but conventional simple cold storage of these ischemic organs can lead to poor graft function after transplantation. Experimental normothermic machine perfusio...

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Bibliographic Details
Published in:Transplantation proceedings Vol. 40; no. 5; pp. 1306 - 1309
Main Authors: Tolboom, H, Milwid, J.M, Izamis, M.L, Uygun, K, Berthiaume, F, Yarmush, M.L
Format: Journal Article
Language:English
Published: New York, NY Elsevier Inc 01-06-2008
Elsevier Science
Subjects:
Alanine Transaminase - blood
Animals
Bilirubin - blood
Biological and medical sciences
Cold Temperature
Death
Fundamental and applied biological sciences. Psychology
Fundamental immunology
Humans
Ischemia - physiopathology
Liver Circulation
Medical sciences
Models, Animal
Patient Selection
Rats
Reperfusion - methods
Reperfusion Injury - physiopathology
Surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Temperature
Tissue, organ and graft immunology
Rat
Digestive system
Liver
Rodentia
Cardiovascular disease
Transplantation
Cold storage
Medicine
Vertebrata
Mammalia
Organ preservation
Treatment
Ischemia
Sequential
Perfusion
Surgery
Animal
Graft
Hypothermia
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Summary:Abstract Extending transplant criteria to include livers obtained from donors after cardiac death (DCD) could increase the liver donor pool, but conventional simple cold storage of these ischemic organs can lead to poor graft function after transplantation. Experimental normothermic machine perfusion has previously proven to be useful for the recovery and preservation of DCD livers, but it is more complicated than conventional cold storage, and, therefore, is perhaps not practical during the entire preservation period. In clinical situations, the combined use of simple cold storage and normothermic perfusion preservation of DCD livers might be more realistic, but even a brief period of cold storage prior to normothermic preservation has been suggested to have a negative impact on graft viability. In this study we show that rat livers subjected to 45 minutes of ex vivo warm ischemia followed by 2 hours of simple cold storage can be reclaimed by 4 hours of normothermic machine perfusion. These livers could be orthotopically transplanted into syngeneic recipients with 100% survival after 4 weeks (N = 10), similar to the survival of animals that received fresh livers that were stored on ice in University of Wisconsin (UW) solution for 6 hours (N = 6). On the other hand, rats that received ischemic livers preserved on ice in UW solution for 6 hours (N = 6) all died within 12 hours after transplantation. These results suggest that normothermic perfusion can be used to reclaim DCD livers subjected to an additional period of cold ischemia during hypothermic storage.
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ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2008.03.100