Noninvasive Detection of Ischemic Vascular Damage in a Pig Model of Liver Donation After Circulatory Death.

Autor: Ember KJI; Department of Chemistry, University of Edinburgh, Edinburgh, United Kingdom., Hunt F; Edinburgh Transplant Centre, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom., Jamieson LE; Technology and Innovation Centre, University of Strathclyde, Glasgow, United Kingdom., Hallett JM; Centre for Regenerative Medicine, University of Edinburgh, Edinburgh, United Kingdom., Esser H; Centre for Regenerative Medicine, University of Edinburgh, Edinburgh, United Kingdom., Kendall TJ; Edinburgh Pathology Department, The Royal Infirmary of Edinburgh, United Kingdom.; University of Edinburgh Centre for Inflammation Research, Edinburgh, United Kingdom., Clutton RE; Roslin Institute, University of Edinburgh, Edinburgh, United Kingdom., Gregson R; Roslin Institute, University of Edinburgh, Edinburgh, United Kingdom., Faulds K; Technology and Innovation Centre, University of Strathclyde, Glasgow, United Kingdom., Forbes SJ; Centre for Regenerative Medicine, University of Edinburgh, Edinburgh, United Kingdom., Oniscu GC; Edinburgh Transplant Centre, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom.; Department of Clinical Sciences, University of Edinburgh, Edinburgh, United Kingdom., Campbell CJ; Department of Chemistry, University of Edinburgh, Edinburgh, United Kingdom.
Jazyk: angličtina
Zdroj: Hepatology (Baltimore, Md.) [Hepatology] 2021 Jul; Vol. 74 (1), pp. 428-443. Date of Electronic Publication: 2021 Jun 15.
DOI: 10.1002/hep.31701
Abstrakt: Background and Aims: Liver graft quality is evaluated by visual inspection prior to transplantation, a process highly dependent on the surgeon's experience. We present an objective, noninvasive, quantitative way of assessing liver quality in real time using Raman spectroscopy, a laser-based tool for analyzing biomolecular composition.
Approach and Results: A porcine model of donation after circulatory death (DCD) with normothermic regional perfusion (NRP) allowed assessment of liver quality premortem, during warm ischemia (WI) and post-NRP. Ten percent of circulating blood volume was removed in half of experiments to simulate blood recovery for DCD heart removal. Left median lobe biopsies were obtained before circulatory arrest, after 45 minutes of WI, and after 2 hours of NRP and analyzed using spontaneous Raman spectroscopy, stimulated Raman spectroscopy (SRS), and staining. Measurements were also taken in situ from the porcine liver using a handheld Raman spectrometer at these time points from left median and right lateral lobes. Raman microspectroscopy detected congestion during WI by measurement of the intrinsic Raman signal of hemoglobin in red blood cells (RBCs), eliminating the need for exogenous labels. Critically, this microvascular damage was not observed during WI when 10% of circulating blood was removed before cardiac arrest. Two hours of NRP effectively cleared RBCs from congested livers. Intact RBCs were visualized rapidly at high resolution using SRS. Optical properties of ischemic livers were significantly different from preischemic and post-NRP livers as measured using a handheld Raman spectrometer.
Conclusions: Raman spectroscopy is an effective tool for detecting microvascular damage which could assist the decision to use marginal livers for transplantation. Reducing the volume of circulating blood before circulatory arrest in DCD may help reduce microvascular damage.
(© 2021 The Authors. HEPATOLOGY published by Wiley Periodicals LLC on behalf of American Association for the Study of Liver Diseases.)
Databáze: MEDLINE
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