scholarly journals Evaluation of Liver Quality after Circulatory Death versus Brain Death: A Comparative Preclinical Pig Model Study

2020 ◽  
Vol 21 (23) ◽  
pp. 9040
Author(s):  
Jérôme Danion ◽  
Raphael Thuillier ◽  
Géraldine Allain ◽  
Patrick Bruneval ◽  
Jacques Tomasi ◽  
...  
Keyword(s):  
Brain Death ◽  
Ischemia Reperfusion Injury ◽  
Ischemia Reperfusion ◽  
Pig Model ◽  
Organ Shortage ◽  
Hepatic Transplantation ◽  
Model Study ◽  
Survival Pathways ◽  
Interesting Possibility ◽  
Circulatory Death

The current organ shortage in hepatic transplantation leads to increased use of marginal livers. New organ sources are needed, and deceased after circulatory death (DCD) donors present an interesting possibility. However, many unknown remains on these donors and their pathophysiology regarding ischemia reperfusion injury (IRI). Our hypothesis was that DCD combined with abdominal normothermic regional recirculation (ANOR) is not inferior to deceased after brain death (DBD) donors. We performed a mechanistic comparison between livers from DBD and DCD donors in a highly reproducible pig model, closely mimicking donor conditions encountered in the clinic. DCD donors were conditioned by ANOR. We determined that from the start of storage, pro-lesion pathways such as oxidative stress and cell death were induced in both donor types, but to a higher extent in DBD organs. Furthermore, pro-survival pathways, such as resistance to hypoxia and regeneration showed activation levels closer to healthy livers in DCD-ANOR rather than in DBD organs. These data highlight critical differences between DBD and DCD-ANOR livers, with an apparent superiority of DCD in terms of quality. This confirms our hypothesis and further confirms previously demonstrated benefits of ANOR. This encourages the expended use of DCD organs, particularly with ANOR preconditioning.

scholarly journals Impact of Three Methods of Ischemic Preconditioning on Ischemia-Reperfusion Injury in a Pig Model of Liver Transplantation

2021 ◽  
pp. 1-10
Author(s):  
Alessandro Rodrigo Belon ◽  
Ana Cristina Aoun Tannuri ◽  
Daniel de Albuquerque Rangel Moreira ◽  
Jose Luiz Figueiredo ◽  
Alessandra Matheus da Silva ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Reperfusion Injury ◽  
Ischemic Preconditioning ◽  
Ischemia Reperfusion Injury ◽  
Ischemia Reperfusion ◽  
Pig Model

scholarly journals Pretreatment Donors after Circulatory Death with Simvastatin Alleviates Liver Ischemia Reperfusion Injury through a KLF2-Dependent Mechanism in Rat

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Zhongzhong Liu ◽  
Xingjian Zhang ◽  
Qi Xiao ◽  
Shaojun Ye ◽  
Chin-Hui Lai ◽  
...  
Keyword(s):  
Reperfusion Injury ◽  
Target Genes ◽  
Ischemia Reperfusion Injury ◽  
Ischemia Reperfusion ◽  
Male Rats ◽  
Control Group ◽  
Isolated Perfused Rat Liver ◽  
Enzyme Release ◽  
Circulatory Death ◽  
Dependent Mechanism

Objective. Severe hepatic ischemia reperfusion injury (IRI) can result in poor short- and long-term graft outcome after transplantation. The way to improve the viability of livers from donors after circulatory death (DCD) is currently limited. The aim of the present study was to explore the protective effect of simvastatin on DCD livers and investigate the underlying mechanism. Methods. 24 male rats randomly received simvastatin or its vehicle. 30 min later, rat livers were exposed to warm ischemia in situ for 30 min. Livers were removed and cold-stored in UW solution for 24 h, subsequently reperfused for 60 min with an isolated perfused rat liver system. Liver injury was evaluated during and after warm reperfusion. Results. Pretreatment of DCD donors with simvastatin significantly decreased IRI liver enzyme release, increased bile output and ATP, and ameliorated hepatic pathological changes. Simvastatin maintained the expression of KLF2 and its protective target genes (eNOS, TM, and HO-1), reduced oxidative stress, inhibited innate immune responses and inflammation, and increased the expression of Bcl-2/Bax to suppress hepatocyte apoptosis compared to DCD control group. Conclusion. Pretreatment of DCD donors with simvastatin improves DCD livers’ functional recovery probably through a KLF2-dependent mechanism. These data suggest that simvastatin may provide a potential benefit for clinical DCD liver transplantation.

scholarly journals The Impact of Ischemia/Reperfusion Injury on Liver Allografts from Deceased after Cardiac Death versus Deceased after Brain Death Donors

PLoS ONE ◽  
2016 ◽  
Vol 11 (2) ◽  
pp. e0148815 ◽  
Author(s):  
Jin Xu ◽  
Blayne Amir Sayed ◽  
Ana Maria Casas-Ferreira ◽  
Parthi Srinivasan ◽  
Nigel Heaton ◽  
...  
Keyword(s):  
Brain Death ◽  
Reperfusion Injury ◽  
Cardiac Death ◽  
Ischemia Reperfusion Injury ◽  
Ischemia Reperfusion ◽  
The Impact

scholarly journals Antioxidant Solution in Combination with Angiotensin-(1-7) Provides Myocardial Protection in Langendorff-Perfused Rat Hearts

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Michaela Andrä ◽  
Miriam Russ ◽  
Susanne Jauk ◽  
Mariana Lamacie ◽  
Ingrid Lang ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Myocardial Protection ◽  
Ischemia Reperfusion Injury ◽  
Organ Procurement ◽  
Ischemia Reperfusion ◽  
Morphological Alteration ◽  
Organ Shortage ◽  
Cold Ischemia ◽  
Rat Hearts ◽  
Perfused Rat Hearts

As progressive organ shortage in cardiac transplantation demands extension of donor criteria, effort is needed to optimize graft survival. Reactive oxygen and nitrogen species, generated during organ procurement, transplantation, and reperfusion, contribute to acute and late graft dysfunction. The combined application of diverse substances acting via different molecular pathways appears to be a reasonable approach to face the complex mechanism of ischemia reperfusion injury. Thus, an antioxidant solution containing α-ketoglutaric acid, 5-hydroxymethylfurfural, N-acetyl-L-methionine, and N-acetyl-selenium-L-methionine was combined with endogenous angiotensin-(1-7). Its capacity of myocardial protection was investigated in isolated Langendorff-perfused rat hearts subjected to warm and cold ischemia. The physiological cardiac parameters were assessed throughout the experiments. Effects were evaluated via determination of the oxidative stress parameters malondialdehyde and carbonyl proteins as well as immunohistochemical and ultrastructural tissue analyses. It was shown that a combination of 20% (v/v) antioxidant solution and 220 pM angiotensin-(1-7) led to the best results with a preservation of heart tissue against oxidative stress and morphological alteration. Additionally, immediate cardiac recovery (after warm ischemia) and normal physiological performance (after cold ischemia) were recorded. Overall, the results of this study indicate substantial cardioprotection of the novel combination with promising prospective for future clinical use.

Sign in / Sign up

Export Citation Format

Share Document