title: Rewarming preservation by organ perfusion system for donation after cardiac death liver grafts in pigs.
abstract: BACKGROUND
  Use of grafts from donors after cardiac death (DCD) would greatly contribute to the expansion of the donor organ pool. However, this requires the development of novel preservation methods to recover the organ from changes due to warm ischemia time (WIT).
  
  
  METHODS
  Porcine livers were perfused with a newly developed machine perfusion (MP) system. The livers were perfused with modified University of Wisconsin solution (UW) - gluconate. All grafts were procured after acute hemorrhagic shock with the ventilator off. For group 1 (n = 6), grafts were procured after WIT of 60 minutes and preserved by hypothermic MP (HMP) for 3 hours. For group 2 (n = 5), grafts were preserved with 2 hours of simple cold storage (SCS) and HMP for 2 hours. For group 3 (n = 6), grafts were preserved with 2 hours of SCS and rewarming up to 25°C by MP for 2 hours (RMP). The preserved liver grafts were transplanted orthotopically.
  
  
  RESULTS
  The alanine aminotransferase level in perfusate in RMP during perfusion preservation was maintained at less than that of HMP. The levels of aspartate aminotransferase and lactate dehydrogenase in the 2 hours after reperfusion were significantly lower in group 3. Histologically, the necrosis of hepatocytes was less severe in group 3. The survival rate in group 3 was 2/4, but 0/4 in the other group.
  
  
  CONCLUSIONS
  RMP is expected to facilitate the recovery of the DCD liver grafts.
authors.affiliation: National Center for Child Health and Development, Tokyo, Japan; Tokyo Metropolitan University, Mechanical Engineering, Tokyo, Japan. Electronic address: mtnnot@yahoo.co.jp.
authors.forename: N
authors.initials: N
authors.lastname: Matsuno
authors.affiliation: Tokyo Metropolitan University, Mechanical Engineering, Tokyo, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Obara
authors.affiliation: National Center for Child Health and Development, Tokyo, Japan.
authors.forename: R
authors.initials: R
authors.lastname: Watanabe
authors.affiliation: National Center for Child Health and Development, Tokyo, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Iwata
authors.affiliation: National Center for Child Health and Development, Tokyo, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Kono
authors.affiliation: National Center for Child Health and Development, Tokyo, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Fujiyama
authors.affiliation: Tokyo University of Pharmacology and Life Science, Clinical Pharmacology, Tokyo, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Hirano
authors.affiliation: National Center for Child Health and Development, Tokyo, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Kanazawa
authors.affiliation: National Center for Child Health and Development, Tokyo, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Enosawa
mesh_terms: D000241:Adenosine / Q000494:pharmacology; D000410:Alanine Transaminase / Q000378:metabolism; D000493:Allopurinol / Q000494:pharmacology; D000818:Animals; D001219:Aspartate Aminotransferases / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D050377:Cold Ischemia; D004195:Disease Models, Animal; D005260:Female; D005978:Glutathione / Q000494:pharmacology; D006085:Graft Survival; D006323:Heart Arrest; D006498:Hepatectomy; D007328:Insulin / Q000494:pharmacology; D007770:L-Lactate Dehydrogenase / Q000378:metabolism; D008099:Liver / Q000187:drug effects / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods*; D009336:Necrosis; D009926:Organ Preservation / Q000009:adverse effects / Q000379:methods*; D019188:Organ Preservation Solutions / Q000494:pharmacology; D010477:Perfusion / Q000009:adverse effects / Q000379:methods*; D011887:Raffinose / Q000494:pharmacology; D015427:Reperfusion Injury / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D017694:Rewarming / Q000009:adverse effects / Q000379:methods*; D034421:Sus scrofa; D013997:Time Factors; D020858:Tissue and Organ Harvesting / Q000009:adverse effects / Q000379:methods*; D052096:Warm Ischemia
chemical_list: D015415:Biomarkers; D007328:Insulin; D019188:Organ Preservation Solutions; C055206:University of Wisconsin-lactobionate solution; D000493:Allopurinol; D007770:L-Lactate Dehydrogenase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D005978:Glutathione; D000241:Adenosine; D011887:Raffinose