Peng Li1, Yong-Feng Liu1, Lei Yang1. 1. Department of Organ Transplantation, First Affiliated Hospital, China Medical University, Shenyang, China.
Abstract
AIMS: We have compared hypothermic oxygenated machine perfusion (HOPE) with simple cold storage (SCS) in liver preservation with a porcine model of donor after cardiac death (DCD). METHODS: A DCD model was developed in 10 hybrid pigs by apnea. Livers were harvested after 30 min of warm ischemia (WI) and randomly preserved using HOPE (HOPE group, five pigs, dual perfusion via portal vein and hepatic artery) or SCS (SCS group, five pigs) methods. Levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), glucose, lactic acid, and pyruvic acid were measured by microdialysis analyzer. RESULTS: Histological morphology of liver tissue was significantly affected by 30 min of WI. HOPE significantly delayed histological morphology change and cell apoptosis. Release of ALT and AST was significantly higher in SCS group compared to HOPE group (p < 0.05) during 12-18 h of preservation. Levels of glucose, lactic acid, and pyruvic acid in HOPE group were significantly closer to baseline than that in SCS group after 18 h of preservation (p < 0.05). CONCLUSIONS: HOPE is supported for the preservation of liver from DCD due to significant improvement in the prevention of hepatocellular damage and protection of liver function and metabolic activity compared with SCS.
AIMS: We have compared hypothermic oxygenated machine perfusion (HOPE) with simple cold storage (SCS) in liver preservation with a porcine model of donor after cardiac death (DCD). METHODS: A DCD model was developed in 10 hybrid pigs by apnea. Livers were harvested after 30 min of warm ischemia (WI) and randomly preserved using HOPE (HOPE group, five pigs, dual perfusion via portal vein and hepatic artery) or SCS (SCS group, five pigs) methods. Levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), glucose, lactic acid, and pyruvic acid were measured by microdialysis analyzer. RESULTS: Histological morphology of liver tissue was significantly affected by 30 min of WI. HOPE significantly delayed histological morphology change and cell apoptosis. Release of ALT and AST was significantly higher in SCS group compared to HOPE group (p < 0.05) during 12-18 h of preservation. Levels of glucose, lactic acid, and pyruvic acid in HOPE group were significantly closer to baseline than that in SCS group after 18 h of preservation (p < 0.05). CONCLUSIONS: HOPE is supported for the preservation of liver from DCD due to significant improvement in the prevention of hepatocellular damage and protection of liver function and metabolic activity compared with SCS.