Novel Dynamic Organ Storage System Enhances Liver Graft Function in a Porcine Donation After Circulatory Death Model.

Autor:	Shishido Y; From the Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee., Tracy KM; From the Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee., Petrovic M; Vanderbilt University Medical School , Nashville, Tennessee., Adesanya T; Vanderbilt University Medical School , Nashville, Tennessee., Fortier AK; Vanderbilt University Medical School , Nashville, Tennessee., Raietparvar K; Vanderbilt University Medical School , Nashville, Tennessee., Glomp GA; Vanderbilt University Medical School , Nashville, Tennessee., Simonds E; Vanderbilt University Medical School , Nashville, Tennessee., Harris TR; Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tennessee., Simon V; Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tennessee., Tucker WD; Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tennessee., Petree B; Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tennessee., Cortelli M; Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tennessee., Cardwell NL; Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tennessee., Crannell C; Division of Kidney and Pancreas Transplantation, Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee., Liang J; Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee., Murphy AC; Department of Biochemistry and Molecular Biology, The Huck Institutes of the Life Sciences, Pennsylvania State University, State College, Pennsylvania., Fields BL; Department of Biochemistry and Molecular Biology, The Huck Institutes of the Life Sciences, Pennsylvania State University, State College, Pennsylvania., McReynolds M; Department of Biochemistry and Molecular Biology, The Huck Institutes of the Life Sciences, Pennsylvania State University, State College, Pennsylvania., Demarest CT; Department of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee., Ukita R; Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.; Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee., Rizzari M; From the Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee., Montenovo M; From the Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee., Magliocca JF; From the Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee., Karp SJ; From the Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee., Rauf MA; From the Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee., Shah AS; Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tennessee., Bacchetta M; Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.; Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee.
Jazyk:	angličtina
Zdroj:	ASAIO journal (American Society for Artificial Internal Organs : 1992) [ASAIO J] 2024 Dec 18. Date of Electronic Publication: 2024 Dec 18.
DOI:	10.1097/MAT.0000000000002365
Abstrakt:	Donation after circulatory death (DCD) livers face increased risks of critical complications when preserved with static cold storage (SCS). Although machine perfusion (MP) may mitigate these risks, its cost and logistical complexity limit widespread application. We developed the Dynamic Organ Storage System (DOSS), which delivers oxygenated perfusate at 10°C with minimal electrical power requirement and allows real-time effluent sampling in a portable cooler. In a porcine DCD model, livers were preserved using DOSS or SCS for 10 hours and evaluated with 4 hours of normothermic MP, with n = 5 per group. After 4 hours of normothermic MP, the DOSS group demonstrated significantly lower perfusate lactate (p = 0.023), increased perfusate fibrinogen (p = 0.005), higher oxygen consumption (p = 0.018), greater bile production (p = 0.013), higher bile bicarbonate levels (p = 0.035) and bile/perfusate sodium ratio (p = 0.002), and lower hepatic arterial resistance after phenylephrine administration (p = 0.018). Histological analysis showed lower apoptotic markers in DOSS-preserved livers, with fewer cleaved caspase-3 (p = 0.039) and terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling (TUNEL; p = 0.009) positive cells. These findings suggest that DOSS can enhance DCD allograft function during transport, offering potential clinical benefits and contributing to the expansion of the donor pool. Competing Interests: Disclosure: Provisional patent for the Dynamic Organ Storage System (Reference No. VU033034) (Y.S., K.M.T., T.R.H., M.C., C.T.D., R.U., A.S.S., M.B.). The other authors have no conflicts of interest to report. (Copyright © ASAIO 2024.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu