title: Pretransplant screening and evaluation of liver graft viability using machine perfusion preservation in porcine transplantation.
abstract: A novel method using machine perfusion for pretransplant screening and evaluation of the viability of liver grafts has been proposed, seeking to prevent severe ischemia-reperfusion injury and to reduce the risk of primary graft nonfunction. This study sought to evaluate the viability of critical grafts, which were obtained from expanded criteria donors or donation after cardiac death donors during preservation with a new machine preservation perfusion system (NES-01). The normalized pressure transition in the hepatic artery was employed as an evaluation index for liver viability. As a result, the normalized pressure (p/p(0)) in the hepatic artery showed a distinctive transition under each experimental conditions controlled by warm ischemic time (WIT). The high viability graft, obtained under the condition of WIT as 0 minutes (WIT0), showed a quick response to hepatic artery pressure after initiating perfusion, whereas the normalized pressure showed a sudden decrease. In contrast, the normalized pressure among WIT60, which may cause the graft to lose viability, showed a poor hepatic artery response. These findings corresponded to the cumulative release of enzymes. The findings of our study suggest that monitoring of the pressure drop rate in the hepatic artery during machine perfusion can be used to evaluate liver graft viability.
authors.affiliation: Department of Mechanical Engineering, Tokyo Metropolitan University, Tokyo, Japan. obara@tmu.ac.jp
authors.forename: H
authors.initials: H
authors.lastname: Obara
authors.forename: N
authors.initials: N
authors.lastname: Matsuno
authors.forename: S
authors.initials: S
authors.lastname: Enosawa
authors.forename: T
authors.initials: T
authors.lastname: Shigeta
authors.forename: H
authors.initials: H
authors.lastname: Huai-Che
authors.forename: T
authors.initials: T
authors.lastname: Hirano
authors.forename: M
authors.initials: M
authors.lastname: Muto
authors.forename: M
authors.initials: M
authors.lastname: Kasahara
authors.forename: S
authors.initials: S
authors.lastname: Uemoto
authors.forename: H
authors.initials: H
authors.lastname: Mizunuma
mesh_terms: D000410:Alanine Transaminase / Q000097:blood; D000818:Animals; D001219:Aspartate Aminotransferases / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D004867:Equipment Design; D006499:Hepatic Artery / Q000503:physiopathology / Q000601:surgery*; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008099:Liver / Q000098:blood supply / Q000201:enzymology / Q000473:pathology / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D009926:Organ Preservation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D010477:Perfusion / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D015427:Reperfusion Injury / Q000209:etiology / Q000517:prevention & control; D013552:Swine; D013997:Time Factors; D014022:Tissue Survival; D020858:Tissue and Organ Harvesting / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D052096:Warm Ischemia
chemical_list: D015415:Biomarkers; D007770:L-Lactate Dehydrogenase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase