A novel model for ex situ reperfusion of the human liver following subnormothermic machine perfusion.

Autor:	Avruch JH; Center for Engineering in Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.; Transplant Center, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA., Bruinsma BG; Center for Engineering in Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.; Transplant Center, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA., Weeder PD; Center for Engineering in Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.; Section of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Sridharan GV; Center for Engineering in Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA., Porte RJ; Section of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Yeh H; Transplant Center, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA., Markmann JF; Transplant Center, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA., Uygun K; Center for Engineering in Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Jazyk:	angličtina
Zdroj:	Technology [Technology (Singap World Sci)] 2017 Dec; Vol. 5 (4), pp. 196-200. Date of Electronic Publication: 2017 Nov 10.
DOI:	10.1142/S2339547817500108
Abstrakt:	Machine perfusion-based organ preservation techniques are prudently transitioning into clinical practice. Although experimental data is compelling, the outcomes in the highly variable clinical donation-transplantation setting are unpredictable. Here, we offer an intermediate tool for pre-clinical assessment of human donor livers. We present a model for ex situ reperfusion of discarded human livers and report on its application in three human livers that have undergone subnormothermic (21°C) machine perfusion as an experimental preservation method. During reperfusion, the livers macroscopically reperfused in the first 15 minutes, and remained visually well-perfused for 3 hours of ex situ reperfusion. Bile production and oxygen consumption were observed throughout ex situ reperfusion. ATP levels increased 4.25-fold during SNMP. Between the end of SNMP and the end of reperfusion ATP levels dropped 45%. ALT levels in blood increased rapidly in the first 30 minutes and ALT release continued to taper off towards the end of perfusion. Release of CRP, TNF-α, IL-1β, and IL-12, IFN-γ was sustained during reperfusion. These findings support the use of this model for the evaluation of novel human liver preservation techniques. Competing Interests: DISCLOSURES Dr. Uygun is inventor on pending patents relevant to this study (WO/2011/002926; WO/2011/35223) and Drs. Uygun and Bruinsma have a provisional patent application relevant to this study (MGH 22743). Dr. Uygun has a financial interest in Organ Solutions, a company focused on developing organ preservation technology. Dr. Uygun’s interests are managed by the MGH and Partners HealthCare in accordance with their conflict of interest policies.
Databáze:	MEDLINE
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