Extracorporeal Hypothermic Perfusion Device for Intestinal Graft Preservation to Decrease Ischemic Injury During Transportation.
BACKGROUND
The small intestine is one of the most ischemia-sensitive organs used in transplantation. To better preserve the intestinal graft viability and decrease ischemia-reperfusion injury, a device for extracorporeal perfusion was developed. We present the results for the first series of perfused human intestine with an intestinal perfusion unit (IPU).


METHODS
Five human intestines were procured for the protocol. (1) An experimental segment was perfused by the IPU delivering cold preservation solution to the vascular and luminal side continually at 4 ºC for 8 h. (2) Control (jejunum and ileum) segments were preserved in static cold preservation. Tissue samples were obtained for histopathologic grading according to the Park/Chiu scoring system (0 = normal, 8 = transmural infarction).


RESULTS
Jejunal experimental segments scored 2.2 with the Park/Chiu system compared to the control segments, which averaged 3.2. Overall scoring for ileum experimental and control segments was equal with 1.6.


CONCLUSIONS
This data presents proof of concept that extracorporeal intestinal perfusion is feasible. The evidence shows that the IPU can preserve the viability of human intestine, and histopathologic evaluation of perfused intestine is favorable. Our early results can eventually lead to expanding the possibilities of intestinal preservation.
Armando Salim
AS
Muñoz-Abraham
Roger
R
Patrón-Lozano
Raja R
RR
Narayan
Sami S
SS
Judeeba
Abedalrazaq
A
Alkukhun
Tariq I
TI
Alfadda
Joseph T
JT
Belter
David C
DC
Mulligan
Raffaella
R
Morotti
Joseph P
JP
Zinter
John P
JP
Geibel
Manuel I
MI
Rodríguez-Dávalos
D005112:Extracorporeal Circulation / Q000295:instrumentation*; D006801:Humans; D007036:Hypothermia, Induced; D007421:Intestine, Small / Q000098:blood supply / Q000473:pathology* / Q000637:transplantation; D007511:Ischemia / Q000517:prevention & control*; D009926:Organ Preservation / Q000295:instrumentation* / Q000379:methods; D015427:Reperfusion Injury / Q000473:pathology / Q000517:prevention & control; D013048:Specimen Handling; D046509:Tissue Culture Techniques