title: Comparing Normothermic Machine Perfusion Preservation With Different Perfusates on Porcine Livers From Donors After Circulatory Death.
abstract: The utilization of normothermic machine perfusion (NMP) may be an effective strategy to resuscitate livers from donation after circulatory death (DCD). There is no consensus regarding the efficacy of different perfusates on graft and bile duct viability. The aim of this study was to compare, in an NMP porcine DCD model, the preservation potential of three different perfusates. Twenty porcine livers with 60 min of warm ischemia were separated into four preservation groups: cold storage (CS), NMP with Steen solution (Steen; XVIVO Perfusion Inc., Denver, CO), Steen plus red blood cells (RBCs), or whole blood (WB). All livers were preserved for 10 h and reperfused to simulate transplantation for 24 h. During preservation, the NMP with Steen group presented the highest hepatocellular injury. At reperfusion, the CS group had the lowest bile production and the worst hepatocellular injury compared with all other groups, followed by NMP with Steen; the Steen plus RBC and WB groups presented the best functional and hepatocellular injury outcomes, with WB livers showing lower aspartate aminotransferase release and a trend toward better results for most parameters. Based on our results, a perfusate that contains an oxygen carrier is most effective in a model of NMP porcine DCD livers compared with Steen solution. Specifically, WB-perfused livers showed a trend toward better outcomes compared with Steen plus RBCs.
authors.affiliation: Cleveland Clinic, Cleveland, OH.
authors.forename: Q
authors.initials: Q
authors.lastname: Liu
authors.affiliation: Cleveland Clinic, Cleveland, OH.
authors.forename: A
authors.initials: A
authors.lastname: Nassar
authors.affiliation: Cleveland Clinic, Cleveland, OH.
authors.forename: K
authors.initials: K
authors.lastname: Farias
authors.affiliation: Cleveland Clinic, Cleveland, OH.
authors.forename: L
authors.initials: L
authors.lastname: Buccini
authors.affiliation: Virginia Commonwealth University, Richmond, VA.
authors.forename: M J
authors.initials: MJ
authors.lastname: Mangino
authors.affiliation: Cleveland Clinic, Cleveland, OH.
authors.forename: W
authors.initials: W
authors.lastname: Baldwin
authors.affiliation: Cleveland Clinic, Cleveland, OH.
authors.forename: A
authors.initials: A
authors.lastname: Bennett
authors.affiliation: Cleveland Clinic, Cleveland, OH.
authors.forename: C
authors.initials: C
authors.lastname: O'Rourke
authors.affiliation: Cleveland Clinic, Cleveland, OH.
authors.forename: G
authors.initials: G
authors.lastname: Iuppa
authors.affiliation: Cleveland Clinic, Cleveland, OH.
authors.forename: B G
authors.initials: BG
authors.lastname: Soliman
authors.affiliation: Cleveland Clinic, Cleveland, OH.
authors.forename: D
authors.initials: D
authors.lastname: Urcuyo-Llanes
authors.affiliation: Cleveland Clinic, Cleveland, OH.
authors.forename: T
authors.initials: T
authors.lastname: Okamoto
authors.affiliation: Cleveland Clinic, Cleveland, OH.
authors.forename: T D
authors.initials: TD
authors.lastname: Uso
authors.affiliation: Cleveland Clinic, Cleveland, OH.
authors.forename: J
authors.initials: J
authors.lastname: Fung
authors.affiliation: Cleveland Clinic, Cleveland, OH.
authors.forename: K
authors.initials: K
authors.lastname: Abu-Elmagd
authors.affiliation: Cleveland Clinic, Cleveland, OH.
authors.forename: C
authors.initials: C
authors.lastname: Miller
authors.affiliation: Cleveland Clinic, Cleveland, OH.
authors.forename: C
authors.initials: C
authors.lastname: Quintini
mesh_terms: D000818:Animals; D016757:Death, Sudden, Cardiac; D006439:Hemodynamics; D008099:Liver / Q000502:physiology*; D016031:Liver Transplantation; D009926:Organ Preservation / Q000379:methods*; D010101:Oxygen Consumption; D010477:Perfusion; D012038:Regeneration; D013552:Swine; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000379:methods*; D052096:Warm Ischemia