title: Functional recovery of donation after cardiac death liver graft by continuous machine perfusion preservation in pigs.
abstract: BACKGROUND
  Grafts from donation after cardiac death (DCD) will greatly contribute to the expand the donor pool. However, these grafts may require the development of the preservation methods because of primary nonfunction and severe ischemic bile duct injury.
  
  
  METHODS
  Porcine livers were perfused with a newly developed machine perfusion (MP) system. Each system for the portal vein or the hepatic artery had a roller pump, a flow meter, and a pressure sensor. The livers were perfused with University of Wisconsin (UW)-gluconate at 4°C-6°C for 3 hours after 2 hours simple cold storage (CS). The portal vein flow rate was 0.5 mL/min/g liver (pressure, 10 mm Hg) and the hepatic artery flow rate was 0.2 mL/min/g liver (pressure, 30 mm Hg). Orthotopic liver transplantation was performed in pigs comparing Group 1 (n = 4) procured after acute hemorrhagic shock preserved by MP, Group 2 (n = 3) procured after warm ischemia time (WIT) of 30 minutes with CS preservation, and Group 3 (n = 4) procured with 30 minutes of WIT and MP preservation.
  
  
  RESULTS
  Collected effluent aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) levels in the perfusion solution and serum AST and LDH were significantly lower in Group 1. AST and LDH results were lower in Group 3 than Group 2. Survival rates in Groups 1 and 3 were 3/4, but 0/3 in Group 2.
  
  
  CONCLUSIONS
  MP preservation was a useful promising preservation mode for DCD liver grafts.
authors.affiliation: National Center for Child Health and Development, Tokyo, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Shigeta
authors.forename: N
authors.initials: N
authors.lastname: Matsuno
authors.forename: H
authors.initials: H
authors.lastname: Obara
authors.forename: H
authors.initials: H
authors.lastname: Mizunuma
authors.forename: H
authors.initials: H
authors.lastname: Kanazawa
authors.forename: H
authors.initials: H
authors.lastname: Tanaka
authors.forename: A
authors.initials: A
authors.lastname: Fukuda
authors.forename: S
authors.initials: S
authors.lastname: Sakamoto
authors.forename: M
authors.initials: M
authors.lastname: Kasahara
authors.forename: S
authors.initials: S
authors.lastname: Uemoto
authors.forename: S
authors.initials: S
authors.lastname: Enosawa
mesh_terms: D000241:Adenosine / Q000008:administration & dosage; D000493:Allopurinol / Q000008:administration & dosage; D000818:Animals; D001219:Aspartate Aminotransferases / Q000378:metabolism; D003080:Cold Temperature; D004867:Equipment Design; D005942:Gluconates / Q000008:administration & dosage*; D005978:Glutathione / Q000008:administration & dosage; D006499:Hepatic Artery / Q000601:surgery*; D007328:Insulin / Q000008:administration & dosage; D007770:L-Lactate Dehydrogenase / Q000378:metabolism; D008099:Liver / Q000098:blood supply / Q000201:enzymology / Q000601:surgery*; D016031:Liver Transplantation; D009926:Organ Preservation / Q000295:instrumentation / Q000379:methods*; D019188:Organ Preservation Solutions / Q000008:administration & dosage*; D010477:Perfusion / Q000295:instrumentation / Q000379:methods*; D011169:Portal Vein / Q000601:surgery*; D011887:Raffinose / Q000008:administration & dosage; D013552:Swine; D013997:Time Factors; D052096:Warm Ischemia / Q000009:adverse effects
chemical_list: D005942:Gluconates; D007328:Insulin; D019188:Organ Preservation Solutions; C055206:University of Wisconsin-lactobionate solution; D000493:Allopurinol; D007770:L-Lactate Dehydrogenase; D001219:Aspartate Aminotransferases; D005978:Glutathione; D000241:Adenosine; D011887:Raffinose; C030691:gluconic acid