title: Hypothermic Liver Machine Perfusion With EKPS-1 Solution vs Aqix RS-I Solution: In Vivo Feasibility Study in a Pig Transplantation Model.
abstract: OBJECTIVE
  Hypothermic machine perfusion (HMP) is superior to simple cold storage for kidney preservation. We previous observed in a porcine liver transplantation model increased tumor necrosis factor-alpha (TNF-alpha) production eventually leading to poor recipient survival after HMP using standard kidney perfusion solution (KPS-1) compared with simple cold storage. We compared two solutions for HMP preservation of the liver: enriched KPS-1 (EKPS-1) and Aqix RS-I.
  
  
  METHODS
  Pig livers were obtained after cold flushing with histidine-tryptophan-ketoglutarate solution. Subsequently, the livers were subjected to dual-vessel perfusion with two preservation solutions: EKPS-1 (n = 6) and Aqix RS-I (n = 3). After HMP preservation and transplantation, graft and recipient survival, hepatocellular damage (aspartate aminotransferase concentration), TNF-alpha production, and endothelial cell damage (hyaluronic acid clearance) were recorded.
  
  
  RESULTS
  No primary graft nonfunction was observed. Recipient survival at postoperative day 3 was similar in both groups (33%). Aspartate aminotransferase concentration measured in serum samples after reperfusion was similar in both groups. After reperfusion, TNF-alpha concentration was higher and hyaluronic acid clearance was lower in the EKPS-1 group vs the Aqix RS-I group at 60, 120, and 180 minutes (all P < .05).
  
  
  CONCLUSIONS
  Hypothermic machine perfusion provided adequate longer term graft survival. After reperfusion, TNF-alpha production seems to be reduced, and endothelial cell dysfunction remains pronounced with Aqix RS-1 solution compared with EKPS-1 solution.
authors.affiliation: Abdominal Transplant Surgery Section, Department of Surgery, Catholic University of Leuven, Leuven, Belgium. Katrien.vekemans@med.kuleuven.be
authors.forename: K
authors.initials: K
authors.lastname: Vekemans
authors.forename: Q
authors.initials: Q
authors.lastname: Liu
authors.forename: V
authors.initials: V
authors.lastname: Heedfeld
authors.forename: K
authors.initials: K
authors.lastname: Van de Vel
authors.forename: T
authors.initials: T
authors.lastname: Wylin
authors.forename: J
authors.initials: J
authors.lastname: Pirenne
authors.forename: D
authors.initials: D
authors.lastname: Monbaliu