scholarly journals Experimental perfusion device for preservation of donor’s liver

2017 ◽  
Vol 176 (3) ◽  
pp. 88-92
Author(s):  
S. F. Bagnenko ◽  
O. N. Reznik ◽  
A. E. Skvortsov ◽  
A. V. Lopota ◽  
N. A. Gryaznov ◽  
...  
Keyword(s):  
Biochemical Parameters ◽  
Warm Ischemia ◽  
Central Research ◽  
Machine Perfusion ◽  
Clinical Tests ◽  
Donor Liver ◽  
Porcine Liver ◽  
Design Institute ◽  
Normothermic Perfusion ◽  
Normothermic Machine Perfusion

OBJECTIVE. The authors aimed to develop complex perfusion medical device in order to successfully maintain viability of donor liver until transplantation. MATERIAL AND METHODS. Experimental perfusion device for normothermic perfusion donor’s liver was developed and tested in the Central Research and Experimental-design Institute of Robotics and Technical Cybernetics. RESULTS. The pre-clinical tests were performed on porcine liver. It was demonstrated that normothermic machine perfusion could restore liver function after 30 minutes of warm ischemia time and provide normalization of biochemical parameters of organ functioning.

scholarly journals Human liver stem cell‐derived extracellular vesicles reduce injury in a model of normothermic machine perfusion of rat livers previously exposed to a prolonged warm ischemia

2021 ◽  
Vol 34 (9) ◽  
pp. 1607-1617
Author(s):  
Nicola De Stefano ◽  
Victor Navarro‐Tableros ◽  
Dorotea Roggio ◽  
Alberto Calleri ◽  
Federica Rigo ◽  
...  
Keyword(s):  
Stem Cell ◽  
Extracellular Vesicles ◽  
Human Liver ◽  
Warm Ischemia ◽  
Machine Perfusion ◽  
Normothermic Machine Perfusion ◽  
Rat Livers

scholarly journals Porcine Liver Normothermic Machine Perfusion: Methodological Framework and Potential Pitfalls

2021 ◽  
Vol 8 (1) ◽  
pp. e1276
Author(s):  
Nicholas Gilbo ◽  
Tine Wylin ◽  
Veerle Heedfeld ◽  
Ina Jochmans ◽  
Jacques Pirenne ◽  
...  
Keyword(s):  
Machine Perfusion ◽  
Methodological Framework ◽  
Porcine Liver ◽  
Normothermic Machine Perfusion

scholarly journals Normothermic Machine Perfusion Using an Air/Oxygen Mixer: Reconditioning a Marginal Donor Liver

HPB ◽  
2019 ◽  
Vol 21 ◽  
pp. S776-S777
Author(s):  
F. Di Francesco ◽  
P. Bonsignore ◽  
G. Martucci ◽  
D. Pagano ◽  
D. Cintorino ◽  
...  
Keyword(s):  
Machine Perfusion ◽  
Donor Liver ◽  
Marginal Donor ◽  
Normothermic Machine Perfusion

scholarly journals Cold Preflush of Porcine Kidney Grafts Prior to Normothermic Machine Perfusion Aggravates Ischemia Reperfusion Injury

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Gregor Fabry ◽  
Benedict M. Doorschodt ◽  
Tim Grzanna ◽  
Peter Boor ◽  
Aaron Elliott ◽  
...  
Keyword(s):  
Reperfusion Injury ◽  
Ischemia Reperfusion Injury ◽  
Ischemia Reperfusion ◽  
Warm Ischemia ◽  
Total Output ◽  
Machine Perfusion ◽  
Buffer Solution ◽  
Preservation Method ◽  
Fractional Excretion Of Sodium ◽  
Normothermic Machine Perfusion

Abstract Normothermic machine perfusion (NMP) of kidney grafts is a promising new preservation method to improve graft quality and clinical outcome. Routinely, kidneys are washed out of blood remnants and cooled using organ preservation solutions prior to NMP. Here we assessed the effect of cold preflush compared to direct NMP. After 30 min of warm ischemia, porcine kidneys were either preflushed with cold histidine-tryptophan-ketoglutarate solution (PFNMP group) prior to NMP or directly subjected to NMP (DNMP group) using a blood/buffer solution. NMP was performed at a perfusion pressure of 75 mmHg for 6 h. Functional parameters were assessed as well as histopathological and biochemical analyses. Renal function as expressed by creatinine clearance, fractional excretion of sodium and total output of urine was inferior in PFNMP. Urine protein and neutrophil gelatinase-associated lipocalin (NGAL) concentrations as markers for kidney damage were significantly higher in the PFNMP group. Additionally, increased osmotic nephropathy was found after PFNMP. This study demonstrated that cold preflush prior to NMP aggravates ischemia reperfusion injury in comparison to direct NMP of warm ischemia-damaged kidney grafts. With increasing use of NMP systems for kidneys and other organs, further research into graft flushing during retrieval is warranted.

scholarly journals Normothermic machine perfusion using an air/oxygen mixer: reconditioning a marginal donor liver

HPB ◽  
2019 ◽  
Vol 21 ◽  
pp. S1001
Author(s):  
F. Di Francesco ◽  
P. Bonsignore ◽  
G. Martucci ◽  
D. Pagano ◽  
D. Cintorino ◽  
...  
Keyword(s):  
Machine Perfusion ◽  
Donor Liver ◽  
Marginal Donor ◽  
Normothermic Machine Perfusion

scholarly journals HO-1/BMMSC perfusion using a normothermic machine perfusion system reduces the acute rejection of DCD liver transplantation by regulating NKT cell co-inhibitory receptors in rats

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Huan Cao ◽  
Longlong Wu ◽  
Xuan Tian ◽  
Weiping Zheng ◽  
Mengshu Yuan ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Acute Rejection ◽  
T Cell Activation ◽  
Heme Oxygenase 1 ◽  
Machine Perfusion ◽  
Inhibitory Receptors ◽  
Donor Liver ◽  
Nkt Cell ◽  
Normothermic Machine Perfusion

Abstract Background Liver transplantation (LT) is required in many end-stage liver diseases. Donation after cardiac death (DCD) livers are often used, and treatment of acute rejection (ACR) requires the use of immunosuppressive drugs that are associated with complications. Bone marrow mesenchymal stem cells (BMMSCs) are used in treatment following LT; however, they have limitations, including low colonization in the liver. An optimized BMMSC application method is required to suppress ACR. Methods BMMSCs were isolated and modified with the heme oxygenase 1 (HO-1) gene. HO-1/BMMSCs were perfused into donor liver in vitro using a normothermic machine perfusion (NMP) system, followed by LT into rats. The severity of ACR was evaluated based on liver histopathology. Gene chip technology was used to detect differential gene expression, and flow cytometry to analyze changes in natural killer (NK) T cells. Results NMP induced BMMSCs to colonize the donor liver during in vitro preservation. The survival of HO-1/BMMSCs in liver grafts was significantly longer than that of unmodified BMMSCs. When the donor liver contained HO-1/BMMSCs, the local immunosuppressive effect was improved and prolonged, ACR was controlled, and survival time was significantly prolonged. The application of HO-1/BMMSCs reduced the number of NKT cells in liver grafts, increased the expression of NKT cell co-inhibitory receptors, and reduced NKT cell expression of interferon-γ. Conclusions NK cell and CD8+ T cell activation was inhibited by application of HO-1/BMMSCs, which reduced ACR of transplanted liver. This approach could be developed to enhance the success rate of LT.

scholarly journals Continuous Normothermic Machine Perfusion for Renovation of Extended Criteria Donor Livers Without Recooling in Liver Transplantation: A Pilot Experience

2021 ◽  
Vol 8 ◽  
Author(s):  
Zhitao Chen ◽  
Xitao Hong ◽  
Shanzhou Huang ◽  
Tielong Wang ◽  
Yihao Ma ◽  
...  
Keyword(s):  
Acute Hepatic Failure ◽  
Meld Score ◽  
Decompensated Cirrhosis ◽  
Machine Perfusion ◽  
Donor Liver ◽  
Extended Criteria Donor ◽  
Allograft Function ◽  
Normothermic Machine Perfusion ◽  
End Stage ◽  
Early Allograft Dysfunction

Background: Ischemia injury affects the recovery of liver allograft function. We propose a novel technique aimed at avoiding a second ischemic injury: transplanting an extended criteria donor (ECD) liver directly under normothermic machine perfusion (NMP) without recooling. We studied two cases to evaluate the efficacy and safety of this technique.Methods: The perioperative characteristics and postoperative outcomes of two recipients of ECD livers were analyzed. Both transplantations were performed with continuous normothermic machine perfusion without recooling.Result: In case 1, the cause of donor death was anoxia, and the donor liver had hypernatremia before procurement. The recipient was diagnosed with decompensated cirrhosis. His model for end-stage liver disease (MELD) score was 38. In case 2, the donor liver was from a donor after cardiac death (DCD), and the donor had elevated aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels. The recipient was diagnosed with acute hepatic failure. His MELD score was 35. Both donor livers were maintained under NMP and then transplanted without recooling. The peak ALT and AST levels after surgery were 452 and 770 U/L in case 1 and 100 and 592 U/L in case 2. Neither early allograft dysfunction (EAD) nor primary graft non-function (PNF) was present in these two cases.Conclusion: In conclusion, our results demonstrate that continuous NMP without recooling is efficacious and safe for LT with extended criteria donor livers. Further investigations of this technique will be performed to confirm these promising results.

scholarly journals Normothermic Ex Vivo Machine Perfusion for Liver Grafts Recovered from Donors after Circulatory Death: A Systematic Review and Meta-Analysis

HPB Surgery ◽  
2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Jordan J. Nostedt ◽  
Daniel T. Skubleny ◽  
A. M. James Shapiro ◽  
Sandra Campbell ◽  
Darren H. Freed ◽  
...  
Keyword(s):  
Cold Storage ◽  
Meta Analysis ◽  
Mean Difference ◽  
Large Animal ◽  
Machine Perfusion ◽  
Donation After Circulatory Death ◽  
Economic Implications ◽  
Normothermic Perfusion ◽  
Normothermic Machine Perfusion ◽  
Circulatory Death

As a result of donation after circulatory death liver grafts’ poor tolerance to cold storage, there has been increasing research interest in normothermic machine perfusion. This study aims to systematically review the current literature comparing normothermic perfusion to cold storage in donation after circulatory death liver grafts and complete a meta-analysis of published large animal and human studies. A total of nine porcine studies comparing cold storage to normothermic machine perfusion for donation after circulatory death grafts were included for analysis. There was a significant reduction in AST (mean difference −2291 U/L, CI (−3019, −1563); P ≤ 0.00001) and ALT (mean difference −175 U/L, CI (−266, −85); P=0.0001), for normothermic perfusion relative to static cold storage, with moderate (I2 = 61%) and high (I2 = 96%) heterogeneity, respectively. Total bile production was also significantly higher (mean difference = 174 ml, CI (155, 193); P≤0.00001). Further research focusing on standardization, performance of this technology following periods of cold storage, economic implications, and clinical trial data focused on donation after circulatory death grafts will be helpful to advance this technology toward routine clinical utilization for these grafts.

scholarly journals Subnormothermic Machine Perfusion of Steatotic Livers Results in Increased Energy Charge at the Cost of Anti-Oxidant Capacity Compared to Normothermic Perfusion

Metabolites ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. 246 ◽  
Author(s):  
Negin Karimian ◽  
Siavash Raigani ◽  
Viola Huang ◽  
Sonal Nagpal ◽  
Ehab O. A. Hafiz ◽  
...  
Keyword(s):  
Energy Charge ◽  
Redox Status ◽  
High Energy ◽  
Ex Situ ◽  
Machine Perfusion ◽  
Normothermic Perfusion ◽  
Normothermic Machine Perfusion ◽  
Anti Oxidant ◽  
Human Livers ◽  
The Cost

There continues to be significant debate regarding the most effective mode of ex situ machine perfusion of livers for transplantation. Subnormothermic (SNMP) and normothermic machine perfusion (NMP) are two methods with different benefits. We examined the metabolomic profiles of discarded steatotic human livers during three hours of subnormothermic or normothermic machine perfusion. Steatotic livers regenerate higher stores of ATP during SNMP than NMP. However, there is a significant depletion of available glutathione during SNMP, likely due to an inability to overcome the high energy threshold needed to synthesize glutathione. This highlights the increased oxidative stress apparent in steatotic livers. Rescue of discarded steatotic livers with machine perfusion may require the optimization of redox status through repletion or supplementation of reducing agents.

Sign in / Sign up

Export Citation Format

Share Document