title: Role of vasodilation during normothermic machine perfusion of DCD porcine livers.
abstract: BACKGROUND
  Normothermic machine perfusion (NMP) of the liver is a promising preservation modality that holds the potential to better preserve and even repair marginal grafts. In spite of several literature studies showing the benefits of NMP over cold storage, there is paucity of data regarding the mechanisms involved in the optimization of the microcirculation during preservation of these organs. We present our data on the impact of different vasodilators on DCD porcine livers preserved with NMP.
  
  
  METHODS
  Livers from 15 female Yorkshire pigs (30-40 kg) were subjected to 60 min of WIT followed by 10 h of NMP. Group PC (n = 5) received a prostacyclin analog (epoprostenol sodium) and the AD group (n = 5) received adenosine, whereas group WV (n = 5) was perfused without using any vasodilator. Liver function was assessed by measuring, liver enzyme levels, bile production rate, and histological analysis.
  
  
  RESULTS
  At the end of perfusion, the PC group showed significantly lower AST (583 ± 62 vs. 2471 ± 745 and 2547 ± 690 IU/dl), ALT (41 ± 3 vs. 143 ± 28 and 111 ± 25 IU/dl) and LDH (840 ± 85 vs. 2756 ± 408 and 4153 ± 1569 IU/dl) levels compared to the AD and WV groups respectively (p<0.05). Bile production was significantly higher in the PC group compared to the AD group and WV, respectively (95 ± 9 vs. 37 ± 10 and 45 ± 18ml) (p<0.05). Histological samples of the PC group showed preserved hepatic architecture while those of the AD group and WV showed sinusoidal dilatation, architectural distortion, and profuse intraparenchymal hemorrhage.
  
  
  CONCLUSIONS
  Maintenance of optimal microcirculatory homeostasis using proper vasodilators is a key factor in NMP of DCD livers.
authors.affiliation: Transplantation Center, Department of General Surgery, Cleveland Clinic, OH - USA.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Nassar
authors.forename: Qiang
authors.initials: Q
authors.lastname: Liu
authors.forename: Kevin
authors.initials: K
authors.lastname: Farias
authors.forename: Giuseppe
authors.initials: G
authors.lastname: D'Amico
authors.forename: Laura
authors.initials: L
authors.lastname: Buccini
authors.forename: Daniel
authors.initials: D
authors.lastname: Urcuyo
authors.forename: Dympna
authors.initials: D
authors.lastname: Kelly
authors.forename: Koji
authors.initials: K
authors.lastname: Hashimoto
authors.forename: Bijan
authors.initials: B
authors.lastname: Eghtesad
authors.forename: Teresa Diago
authors.initials: TD
authors.lastname: Uso
authors.forename: Charles
authors.initials: C
authors.lastname: Miller
authors.forename: Cristiano
authors.initials: C
authors.lastname: Quintini
mesh_terms: D000241:Adenosine / Q000494:pharmacology*; D000818:Animals; D001831:Body Temperature / Q000502:physiology*; D011464:Epoprostenol / Q000494:pharmacology*; D005260:Female; D008099:Liver / Q000473:pathology / Q000502:physiology; D016031:Liver Transplantation / Q000379:methods; D008833:Microcirculation / Q000187:drug effects / Q000502:physiology; D009926:Organ Preservation / Q000295:instrumentation / Q000379:methods*; D013552:Swine; D014665:Vasodilator Agents / Q000494:pharmacology
chemical_list: D014665:Vasodilator Agents; D011464:Epoprostenol; D000241:Adenosine