Ischemic postconditioning improves the outcome of organs from donors after cardiac death in a pig liver transplantation model and provides synergistic protection with hypothermic machine perfusion
| Autor: | Shanshan Guo, Zhixing Jia, Yang Yu, Qi Pan, Degong Jia, Zhanyu Song, Yijie Zhang, Yong-Feng Liu, Ying Cheng |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
animal structures Swine Bilirubin medicine.medical_treatment Cold storage Liver transplantation Gastroenterology chemistry.chemical_compound Internal medicine medicine Animals Humans Ischemic Postconditioning Transplantation Machine perfusion business.industry Organ Preservation Malondialdehyde Liver Transplantation Death Perfusion Liver chemistry Apoptosis Reperfusion Injury Tumor necrosis factor alpha business |
| Zdroj: | Clinical Transplantation. 35 |
| ISSN: | 1399-0012 0902-0063 |
| Popis: | Aim This study investigated whether ischemic postconditioning (IPO) improved the outcome of organs from donors after cardiac death and had a synergistic effect with hypothermic machine perfusion (HMP) in a pig liver transplantation model. Methods A donor after cardiac death (DCD) model was developed in 48 healthy Bama miniature pigs randomly divided into four groups: simple cold storage group (SCS group), IPO group, HMP group, HMP-IPO group. The levels of serum alanine aminotransferase (ALT), total bilirubin, histopathological findings, apoptotic activity of hepatocytes, international normalized ratio (INR), tumor necrosis factor-α (TNF-α), and Malondialdehyde (MDA) were compared. Results All recipients in the SCS group died within 6 h after transplantation. The livers of the recipients in the IPO had 50% survival on day 5. HMP allowed 83.3% survival and HMP-IPO allowed 100% survival. After reperfusion, the recipients in the IPO and HMP-IPO group had lower ALT and total bilirubin levels, less Suzuki score, less apoptosis, and less injury to hepatocytes and biliary ducts and attenuated inflammatory response and oxidative load. Conclusions IPO improved the outcome of organs from donors after cardiac death and had a synergistic effect with HMP in the pig liver transplantation model. |
| Databáze: | OpenAIRE |
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