title: Protective role of normothermic machine perfusion during reduced-size liver transplantation in pigs.
abstract: The purpose of this study is to explore whether normothermic machine perfusion (NMP) preservation is superior to cold preservation during reduced-size liver transplantation (RSLT) in pigs. Twenty-four healthy Ba-Ma mini pigs were used (aged >13 months; weight 25-35 kg; regardless of sex). The animals were randomized into 2 groups. In group A (NMP), donor livers were harvested without warm ischemia time and heartbeats and then were connected to the NMP system to reduce the livers' size under the normothermic condition. In group B (University of Wisconsin [UW] solution), donor livers were harvested without warm ischemia time and heartbeats after being perfused by UW solution and were then preserved in 0°C-4°C UW solution to reduce the livers' size under cold conditions. After that, liver transplantation without venovenous bypass was performed. General RSLT information of the pigs from the 2 groups was recorded; the serological indices were measured; and routine pathological examination of liver tissue was observed. A significant difference was observed in the intraoperative bleeding between the 2 groups (P < 0.05), whereas no significant difference was found in the other indices (all P > 0.05). Significant differences of alanine aminotransferase levels, aspartate aminotransferase levels, and lactate dehydrogenase levels between the 2 groups were observed between postoperative days 3 and 5 (P < 0.05). Significant differences of lactic acid levels between the 2 groups were observed between postoperative days 2 and 5 (P < 0.05). Compared with the cold preservation group, the liver tissues of the NMP preservation group only rarely experienced liver cell necrosis and maintained integrities in the hepatic sinusoid spaces and endothelial cells. In conclusion, NMP preservation is superior to cold preservation during RSLT in pigs. Liver Transplantation 22 968-978 2016 AASLD.
authors.affiliation: Departments of General Surgery, Tianjin First Central Hospital, Tianjin, China.
authors.forename: Zhi-Bin
authors.initials: ZB
authors.lastname: Zhang
authors.affiliation: Transplantation Surgery, Tianjin First Central Hospital, Tianjin, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Gao
authors.affiliation: Hepatopancreatobiliary Surgery, Tianjin First Central Hospital, Tianjin, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Shi
authors.affiliation: Transplantation Surgery, Tianjin First Central Hospital, Tianjin, China.|Tianjin Key Laboratory of Organ Transplantation, Tianjin, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Liu
authors.affiliation: Transplantation Surgery, Tianjin First Central Hospital, Tianjin, China.|Tianjin Key Laboratory of Organ Transplantation, Tianjin, China.
authors.forename: Ning
authors.initials: N
authors.lastname: Ma
authors.affiliation: Tianjin Key Laboratory of Organ Transplantation, Tianjin, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Transplantation Surgery, Beijing Friendship Hospital, Beijing, China.
authors.forename: Zhi-Jun
authors.initials: ZJ
authors.lastname: Zhu
mesh_terms: D000241:Adenosine / Q000008:administration & dosage; D000410:Alanine Transaminase / Q000097:blood; D000493:Allopurinol / Q000008:administration & dosage; D000818:Animals; D001219:Aspartate Aminotransferases / Q000097:blood; D050377:Cold Ischemia; D005978:Glutathione / Q000008:administration & dosage; D022781:Hepatocytes / Q000473:pathology; D006801:Humans; D007328:Insulin / Q000008:administration & dosage; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008099:Liver / Q000201:enzymology / Q000473:pathology* / Q000601:surgery; D016031:Liver Transplantation / Q000379:methods*; D009336:Necrosis / Q000517:prevention & control; D009926:Organ Preservation / Q000295:instrumentation / Q000379:methods*; D019188:Organ Preservation Solutions / Q000008:administration & dosage; D010477:Perfusion / Q000295:instrumentation / Q000379:methods*; D011184:Postoperative Period; D011887:Raffinose / Q000008:administration & dosage; D015427:Reperfusion Injury / Q000517:prevention & control*; D013552:Swine; D013556:Swine, Miniature; D013696:Temperature
chemical_list: 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