Comparing Normothermic Machine Perfusion Preservation with Different Perfusates on Porcine Livers from Donors after Circulatory Death

Q. Liu, A. Nassar, K. Farias, L. Buccini, M. J. Mangino, W. Baldwin, A. Bennett, C. O'Rourke, G. Iuppa, B. G. Soliman, D. Urcuyo-Llanes, T. Okamoto, T. D. Uso, J. Fung, K. Abu-Elmagd, C. Miller, C. Quintini

Research output: Contribution to journalArticle

Abstract

The utilization of normothermic machine perfusion (NMP) may be an effective strategy to resuscitate livers from donation after circulatory death (DCD). There is no consensus regarding the efficacy of different perfusates on graft and bile duct viability. The aim of this study was to compare, in an NMP porcine DCD model, the preservation potential of three different perfusates. Twenty porcine livers with 60 min of warm ischemia were separated into four preservation groups: cold storage (CS), NMP with Steen solution (Steen; XVIVO Perfusion Inc., Denver, CO), Steen plus red blood cells (RBCs), or whole blood (WB). All livers were preserved for 10 h and reperfused to simulate transplantation for 24 h. During preservation, the NMP with Steen group presented the highest hepatocellular injury. At reperfusion, the CS group had the lowest bile production and the worst hepatocellular injury compared with all other groups, followed by NMP with Steen; the Steen plus RBC and WB groups presented the best functional and hepatocellular injury outcomes, with WB livers showing lower aspartate aminotransferase release and a trend toward better results for most parameters. Based on our results, a perfusate that contains an oxygen carrier is most effective in a model of NMP porcine DCD livers compared with Steen solution. Specifically, WB-perfused livers showed a trend toward better outcomes compared with Steen plus RBCs.

Original languageEnglish (US)
Pages (from-to)794-807
Number of pages14
JournalAmerican Journal of Transplantation
Volume16
Issue number3
DOIs
StatePublished - Mar 1 2016
Externally publishedYes

Fingerprint

Swine
Perfusion
Liver
Erythrocytes
Wounds and Injuries
Warm Ischemia
Carbon Monoxide
Blood Group Antigens
Aspartate Aminotransferases
Bile Ducts
Bile
Reperfusion
Transplantation
Oxygen
Transplants

ASJC Scopus subject areas

  • Transplantation
  • Immunology and Allergy
  • Pharmacology (medical)

Cite this

Comparing Normothermic Machine Perfusion Preservation with Different Perfusates on Porcine Livers from Donors after Circulatory Death. / Liu, Q.; Nassar, A.; Farias, K.; Buccini, L.; Mangino, M. J.; Baldwin, W.; Bennett, A.; O'Rourke, C.; Iuppa, G.; Soliman, B. G.; Urcuyo-Llanes, D.; Okamoto, T.; Uso, T. D.; Fung, J.; Abu-Elmagd, K.; Miller, C.; Quintini, C.

In: American Journal of Transplantation, Vol. 16, No. 3, 01.03.2016, p. 794-807.

Research output: Contribution to journalArticle

Liu, Q, Nassar, A, Farias, K, Buccini, L, Mangino, MJ, Baldwin, W, Bennett, A, O'Rourke, C, Iuppa, G, Soliman, BG, Urcuyo-Llanes, D, Okamoto, T, Uso, TD, Fung, J, Abu-Elmagd, K, Miller, C & Quintini, C 2016, 'Comparing Normothermic Machine Perfusion Preservation with Different Perfusates on Porcine Livers from Donors after Circulatory Death', American Journal of Transplantation, vol. 16, no. 3, pp. 794-807. https://doi.org/10.1111/ajt.13546
Liu, Q. ; Nassar, A. ; Farias, K. ; Buccini, L. ; Mangino, M. J. ; Baldwin, W. ; Bennett, A. ; O'Rourke, C. ; Iuppa, G. ; Soliman, B. G. ; Urcuyo-Llanes, D. ; Okamoto, T. ; Uso, T. D. ; Fung, J. ; Abu-Elmagd, K. ; Miller, C. ; Quintini, C. / Comparing Normothermic Machine Perfusion Preservation with Different Perfusates on Porcine Livers from Donors after Circulatory Death. In: American Journal of Transplantation. 2016 ; Vol. 16, No. 3. pp. 794-807.
@article{ab297489628042988bd63656d5777ac5,
title = "Comparing Normothermic Machine Perfusion Preservation with Different Perfusates on Porcine Livers from Donors after Circulatory Death",
abstract = "The utilization of normothermic machine perfusion (NMP) may be an effective strategy to resuscitate livers from donation after circulatory death (DCD). There is no consensus regarding the efficacy of different perfusates on graft and bile duct viability. The aim of this study was to compare, in an NMP porcine DCD model, the preservation potential of three different perfusates. Twenty porcine livers with 60 min of warm ischemia were separated into four preservation groups: cold storage (CS), NMP with Steen solution (Steen; XVIVO Perfusion Inc., Denver, CO), Steen plus red blood cells (RBCs), or whole blood (WB). All livers were preserved for 10 h and reperfused to simulate transplantation for 24 h. During preservation, the NMP with Steen group presented the highest hepatocellular injury. At reperfusion, the CS group had the lowest bile production and the worst hepatocellular injury compared with all other groups, followed by NMP with Steen; the Steen plus RBC and WB groups presented the best functional and hepatocellular injury outcomes, with WB livers showing lower aspartate aminotransferase release and a trend toward better results for most parameters. Based on our results, a perfusate that contains an oxygen carrier is most effective in a model of NMP porcine DCD livers compared with Steen solution. Specifically, WB-perfused livers showed a trend toward better outcomes compared with Steen plus RBCs.",
author = "Q. Liu and A. Nassar and K. Farias and L. Buccini and Mangino, {M. J.} and W. Baldwin and A. Bennett and C. O'Rourke and G. Iuppa and Soliman, {B. G.} and D. Urcuyo-Llanes and T. Okamoto and Uso, {T. D.} and J. Fung and K. Abu-Elmagd and C. Miller and C. Quintini",
year = "2016",
month = "3",
day = "1",
doi = "10.1111/ajt.13546",
language = "English (US)",
volume = "16",
pages = "794--807",
journal = "American Journal of Transplantation",
issn = "1600-6135",
publisher = "Wiley-Blackwell",
number = "3",

}

TY - JOUR

T1 - Comparing Normothermic Machine Perfusion Preservation with Different Perfusates on Porcine Livers from Donors after Circulatory Death

AU - Liu, Q.

AU - Nassar, A.

AU - Farias, K.

AU - Buccini, L.

AU - Mangino, M. J.

AU - Baldwin, W.

AU - Bennett, A.

AU - O'Rourke, C.

AU - Iuppa, G.

AU - Soliman, B. G.

AU - Urcuyo-Llanes, D.

AU - Okamoto, T.

AU - Uso, T. D.

AU - Fung, J.

AU - Abu-Elmagd, K.

AU - Miller, C.

AU - Quintini, C.

PY - 2016/3/1

Y1 - 2016/3/1

N2 - The utilization of normothermic machine perfusion (NMP) may be an effective strategy to resuscitate livers from donation after circulatory death (DCD). There is no consensus regarding the efficacy of different perfusates on graft and bile duct viability. The aim of this study was to compare, in an NMP porcine DCD model, the preservation potential of three different perfusates. Twenty porcine livers with 60 min of warm ischemia were separated into four preservation groups: cold storage (CS), NMP with Steen solution (Steen; XVIVO Perfusion Inc., Denver, CO), Steen plus red blood cells (RBCs), or whole blood (WB). All livers were preserved for 10 h and reperfused to simulate transplantation for 24 h. During preservation, the NMP with Steen group presented the highest hepatocellular injury. At reperfusion, the CS group had the lowest bile production and the worst hepatocellular injury compared with all other groups, followed by NMP with Steen; the Steen plus RBC and WB groups presented the best functional and hepatocellular injury outcomes, with WB livers showing lower aspartate aminotransferase release and a trend toward better results for most parameters. Based on our results, a perfusate that contains an oxygen carrier is most effective in a model of NMP porcine DCD livers compared with Steen solution. Specifically, WB-perfused livers showed a trend toward better outcomes compared with Steen plus RBCs.

AB - The utilization of normothermic machine perfusion (NMP) may be an effective strategy to resuscitate livers from donation after circulatory death (DCD). There is no consensus regarding the efficacy of different perfusates on graft and bile duct viability. The aim of this study was to compare, in an NMP porcine DCD model, the preservation potential of three different perfusates. Twenty porcine livers with 60 min of warm ischemia were separated into four preservation groups: cold storage (CS), NMP with Steen solution (Steen; XVIVO Perfusion Inc., Denver, CO), Steen plus red blood cells (RBCs), or whole blood (WB). All livers were preserved for 10 h and reperfused to simulate transplantation for 24 h. During preservation, the NMP with Steen group presented the highest hepatocellular injury. At reperfusion, the CS group had the lowest bile production and the worst hepatocellular injury compared with all other groups, followed by NMP with Steen; the Steen plus RBC and WB groups presented the best functional and hepatocellular injury outcomes, with WB livers showing lower aspartate aminotransferase release and a trend toward better results for most parameters. Based on our results, a perfusate that contains an oxygen carrier is most effective in a model of NMP porcine DCD livers compared with Steen solution. Specifically, WB-perfused livers showed a trend toward better outcomes compared with Steen plus RBCs.

UR - http://www.scopus.com/inward/record.url?scp=84959265395&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84959265395&partnerID=8YFLogxK

U2 - 10.1111/ajt.13546

DO - 10.1111/ajt.13546

M3 - Article

C2 - 26663737

AN - SCOPUS:84959265395

VL - 16

SP - 794

EP - 807

JO - American Journal of Transplantation

JF - American Journal of Transplantation

SN - 1600-6135

IS - 3

ER -