Energetic recovery in porcine grafts by minimally invasive liver oxygenation
| Autor: | Minor, Thomas, Scott III, William E., Rizzari, Michael D., Suszynski, Thomas M., Luer, Bastian, Efferz, Patrik, Papas, Klearchos K., Paul, Andreas, Scott, William E. |
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| Rok vydání: | 2012 |
| Předmět: |
Insufflation
Pathology medicine.medical_specialty Swine medicine.medical_treatment Medizin Urology Liver transplantation Adenosine Triphosphate Parenchyma Animals Medicine Vein Liver preservation medicine.diagnostic_test business.industry Magnetic resonance imaging Oxygenation Liver Transplantation Transplantation medicine.anatomical_structure Liver Reperfusion Surgery Energy Metabolism business |
| Zdroj: | Journal of Surgical Research. 178:e59-e63 |
| ISSN: | 0022-4804 |
| Popis: | Background Gaseous insufflation of oxygen via the venous vascular system has proven to be an effective tool for preventing anoxic tissue injury after extended time periods of ischemic liver preservation. Most experimental studies so far have been undertaken in rat models and include a series of pinpricks into postsinusoidal venules as an outlet for the insufflated gas. Here, we describe a simplified technique for minimally invasive liver oxygenation in porcine grafts, representing a hassle-free access to organ oxygenation without vascular lesions. Methods We retrieved livers from Landrace pigs and cold-stored them in histidine-tryptophan-ketoglutarate solution. Subsequent to 18 h preservation, we treated some livers for an additional 2 h with gaseous oxygen, insufflated via silicone tubing inserted into the suprahepatic caval vein. Gas pressure was limited to 18 mm Hg. We occluded the infrahepatic caval vein with a bulldog clamp. Gas bubbles left the graft via the portal vein. We assessed liver integrity by energetic tissue status and by controlled in vitro reperfusion with autologous blood. Results Magnetic resonance imaging demonstrated homogeneous gas distribution in the persufflated tissue without major shunting. Biochemical analyses revealed effective and homogeneous restoration of energetic homeostasis in the ischemic graft before reperfusion. Sinusoidal endothelial clearance of hyaluronic acid was significantly improved upon reperfusion, as was hepatic arterial flow. Parenchymal enzyme loss was concordantly mitigated after minimally invasive liver oxygenation. Conclusions Our results indicate that gaseous oxygen persufflation of the porcine liver is possible without tissue trauma, and significantly enhances post-preservation recovery of the graft. |
| Databáze: | OpenAIRE |
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