Novel oxygenation technique for hypothermic machine perfusion of liver grafts: Validation in porcine Donation after Cardiac Death (DCD) liver model
| Autor: | Jesus Rosado, Adam N Fano, Dayanand Deo, George Dikdan, Ben O'mar Arrington, James V. Guarrera, Nehal Dhaduk, Guergana Panayotova, Matthew McCarty, Prakash Rao, Anthony Giudice, Keri E Lunsford, Flavio Paterno |
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| Rok vydání: | 2020 |
| Předmět: |
Novel technique
medicine.medical_specialty animal structures Tissue and Organ Procurement Swine medicine.medical_treatment Ischemia Cold storage 030230 surgery Liver transplantation 03 medical and health sciences Random Allocation 0302 clinical medicine Internal medicine medicine Animals Machine perfusion business.industry Donation after cardiac death General Medicine Oxygenation Organ Preservation medicine.disease Liver Transplantation Death Oxygen Perfusion medicine.anatomical_structure Liver Hepatocyte Models Animal Cardiology 030211 gastroenterology & hepatology Surgery business Biomarkers |
| Zdroj: | American journal of surgery. 220(5) |
| ISSN: | 1879-1883 |
| Popis: | Background Hypothermic oxygenated machine perfusion improves outcomes in Liver Transplantation, but application is limited as O2 is supplied by a stationary circuit. A novel technique of O2 “pre-charge” in a portable pump would broaden use and further mitigate ischemia damage from organ transport. Methods Porcine DCD livers were randomized to static cold storage (SCS, n = 8) or hypothermic machine perfusion (HMP). HMP was stratified into HMP-O2 (n = 5), non-O2 open to air HMP-RA (n = 5), and non-O2 with sealed lids or no air HMP-NA (n = 5). HMP-O2 was “pre-charged” using 100% O2 delivered at 10 L/min over 15 min. Perfusate and tissue O2 tension (pO2), liver biopsies, and fluid chemistries were analyzed. Results “Pre-charge” achieves sustained tissue and perfusate pO2 vs others. HMP-O2 results in decreased markers of hepatocyte injury: ALT (p Conclusions “Pre-charge” is an effective technique, which allows portability and transport without an O2 source and improves graft parameters. |
| Databáze: | OpenAIRE |
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