Subnormothermic Machine Perfusion for Non-Heart-Beating Donor Liver Grafts Preservation in a Swine Model: A New Strategy to Increase the Donor Pool?
Subnormothermic Machine Perfusion for Non-Heart-Beating Donor Liver Grafts Preservation in a Swine Model: A New Strategy to Increase the Donor Pool?
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DOI：
10.1016/j.transproceed.2012.06.014
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发表时间：
2012-09-01
影响因子：
0.9
通讯作者：
Cillo, U.
中科院分区：
文献类型：
--
作者：
Gringeri, E.;Bonsignore, P.;Cillo, U.
我们以前报道，亚常温机器灌注（sMP; 20摄氏度）是能够提高从非心跳供体（NHBDs）大鼠肝脏的保存。我们比较了sMP和标准冷藏（CS）在心脏骤停60分钟后保存猪肝的效果。在sMP组中，用Celsior在20 ℃下灌注肝脏6小时。CS组在Celsior中于4 ℃保存6小时。为了模拟肝移植，使用机械连续灌注系统在37 ℃下用自体血对sMP和CS保存的肝脏再灌注2小时。再灌注后120 mm时，sMP与CS的天冬氨酸转氨酶水平分别为499 +/- 198与7648 +/- 2806 U/L乳酸脱氢酶分别为1685 +/- 418和12998 +/- 3039 U/L（P < .01）;乳酸分别为4.78 +/- 3.02和10.46 +/- 1.79 mmol/L（P < .01）。sMP组显示出更好的组织病理学结果，肝损伤明显减轻。本研究证实sMP能够复苏来自大型NHBD动物的肝移植物
We previously reported that subnormothermic machine perfusion (sMP; 20 degrees C) is able to improve the preservation of livers obtained from non heart-beating donors (NHBDs) in rats. We have compared sMP and standard cold storage (CS) to preserve pig livers after 60 minutes of cardiac arrest. In the sMP group livers were perfused for 6 hours with Celsior at 20 degrees C. In the CS group they were stored in Celsior at 4 degrees C for 6 hours as usual. To simulate liver transplantation, both sMP- and CS-preserved livers were reperfused using a mechanical continuous perfusion system with autologus blood for 2 hours at 37 degrees C. At 120 mm after reperfusion aspartate aminotransferase levels in sMP versus CS were 499 +/- 198 versus 7648 +/- 2806 U/L (P < .01); lactate dehydrogenase 1685 +/- 418 versus 12998 +/- 3039 U/L (P < .01); and lactic acid 4.78 +/- 3.02 versus 10.46 +/- 1.79 mmol/L (P < .01) respectively. The sMP group showed better histopathologic results with significantly less hepatic damage. This study confirmed that sMP was able to resuscitate liver grafts from large NHBD animals