The Development of a Multiorgan Ex Vivo Perfused Model: Results With the Porcine Liver-Kidney Circuit Over 24 Hours
The Development of a Multiorgan Ex Vivo Perfused Model: Results With the Porcine Liver-Kidney Circuit Over 24 Hours
复制标题
DOI：
10.1111/aor.12003
复制
发表时间：
2013-05-01
影响因子：
2.4
通讯作者：
Dennison, Ashley R.
中科院分区：
文献类型：
--
作者：
Chung, Wen Yuan;Gravante, Gianpiero;Dennison, Ashley R.
我们已经开发了一个体外肝脏-肾脏模型，灌注6小时，其中肾脏作为一个体内平衡器官，与单独的肝脏相比，可以改善电路环境。在本研究中，我们将多器官灌注延长至24小时，以评估结果和随着时间延长而出现的最终缺陷。取5只母猪肝脏和肾脏，灌注24小时以上。体外回路包括离心泵、热交换器和氧合器。该研究的主要终点是从生化和酸碱参数收集的器官功能评估。在肝肾联合循环中，各器官在不同时间内存活并维持可接受的稳态，肝脏（灌注时间长达1923小时）比肾脏（灌注时间为913小时）更长。此外，葡萄糖和肌酐值随着时间的推移显著下降（从灌注的第5和第9小时开始）。在灌注回路中加入肾脏，通过清除正在进行的代谢过程中多余的产物，改善了生化环境。结果是一个更加生理的环境，可以改善未来实验研究的结果。然而，长时间的灌注可能需要一些营养支持，以在整个实验过程中维持器官的活力和功能。
We already developed an ex vivo liver-kidney model perfused for 6h in which the kidney acted as a homeostatic organ to improve the circuit milieu compared to liver alone. In the current study, we extended the multiorgan perfusions to 24h to evaluate the results and eventual pitfalls manifesting with longer durations. Five livers and kidneys were harvested from female pigs and perfused over 24h. The extracorporeal circuit included a centrifugal pump, heat exchanger, and oxygenator. The primary end point of the study was the evaluation of the organ functions as gathered from biochemical and acid-base parameters. In the combined liver-kidney circuit, the organs survived and maintained an acceptable homeostasis for different lengths of time, longer for the liver (up to 1923h of perfusions) than the kidney (913h of perfusions). Furthermore, glucose and creatinine values decreased significantly over time (from the 5th and 9th hour of perfusion onward). The addition of a kidney to the perfusion circuit improved the biochemical environment by removing excess products from ongoing metabolic processes. The consequence is a more physiological milieu that could improve results from future experimental studies. However, it is likely that long perfusions require some nutritional support over the hours to maintain the organ's vitality and functionality throughout the experiments.