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Beneficial Effects of Combined Use of Extracorporeal Membrane Oxygenation and Hypothermic Machine Perfusion in Porcine Donors after Cardiac Death for Liver Transplantation

Grafts from donors after cardiac death (DCD) have greatly contributed to expanding the donor organ pool. This study aimed to determine the benefits of subnormothermic extracorporeal membrane oxygenation (ECMO) and hypothermic machine perfusion (HMP) in a porcine model of DCD liver. Female domestic c...

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Autores principales: Iwata, Hiroyoshi, Obara, Hiromichi, Nakajo, Tetsuya, Kaneko, Hiroki, Okazawa, Yuga, Mohd Zin, Nur Khatijah, Bochimoto, Hiroki, Ohashi, Makito, Kawada, Yoko, Ohara, Mizuho, Yokoo, Hideki, Matsuno, Naoto
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10532259/
https://www.ncbi.nlm.nih.gov/pubmed/37762971
http://dx.doi.org/10.3390/jcm12186031
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author Iwata, Hiroyoshi
Obara, Hiromichi
Nakajo, Tetsuya
Kaneko, Hiroki
Okazawa, Yuga
Mohd Zin, Nur Khatijah
Bochimoto, Hiroki
Ohashi, Makito
Kawada, Yoko
Ohara, Mizuho
Yokoo, Hideki
Matsuno, Naoto
author_facet Iwata, Hiroyoshi
Obara, Hiromichi
Nakajo, Tetsuya
Kaneko, Hiroki
Okazawa, Yuga
Mohd Zin, Nur Khatijah
Bochimoto, Hiroki
Ohashi, Makito
Kawada, Yoko
Ohara, Mizuho
Yokoo, Hideki
Matsuno, Naoto
author_sort Iwata, Hiroyoshi
collection PubMed
description Grafts from donors after cardiac death (DCD) have greatly contributed to expanding the donor organ pool. This study aimed to determine the benefits of subnormothermic extracorporeal membrane oxygenation (ECMO) and hypothermic machine perfusion (HMP) in a porcine model of DCD liver. Female domestic crossbred Large Yorkshire and Landrace pigs weighing approximately 20 kg were used. The abdominal aorta and inferior vena cava were cannulated and connected to an ECMO circuit for in situ perfusion of the abdominal organs at 22 °C for 60 min, 45 min after cardiac death. The pigs were divided into the cold storage (CS) group (n = 3), where liver grafts were preserved at 4 °C, and the HMP group (n = 3), where liver grafts were preserved by HMP at 8–10 °C. After 4 h of preservation, liver function was evaluated using an isolated liver reperfusion model for 2 h. Although the difference was insignificant, the liver effluent enzyme levels in the HMP group were lower than those in the CS group. Furthermore, morphological findings showed fewer injured hepatocytes in the HMP group than in the CS group. The combined use of in situ subnormothermic ECMO and HMP was beneficial for the functional improvement of DCD liver grafts.
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spelling pubmed-105322592023-09-28 Beneficial Effects of Combined Use of Extracorporeal Membrane Oxygenation and Hypothermic Machine Perfusion in Porcine Donors after Cardiac Death for Liver Transplantation Iwata, Hiroyoshi Obara, Hiromichi Nakajo, Tetsuya Kaneko, Hiroki Okazawa, Yuga Mohd Zin, Nur Khatijah Bochimoto, Hiroki Ohashi, Makito Kawada, Yoko Ohara, Mizuho Yokoo, Hideki Matsuno, Naoto J Clin Med Article Grafts from donors after cardiac death (DCD) have greatly contributed to expanding the donor organ pool. This study aimed to determine the benefits of subnormothermic extracorporeal membrane oxygenation (ECMO) and hypothermic machine perfusion (HMP) in a porcine model of DCD liver. Female domestic crossbred Large Yorkshire and Landrace pigs weighing approximately 20 kg were used. The abdominal aorta and inferior vena cava were cannulated and connected to an ECMO circuit for in situ perfusion of the abdominal organs at 22 °C for 60 min, 45 min after cardiac death. The pigs were divided into the cold storage (CS) group (n = 3), where liver grafts were preserved at 4 °C, and the HMP group (n = 3), where liver grafts were preserved by HMP at 8–10 °C. After 4 h of preservation, liver function was evaluated using an isolated liver reperfusion model for 2 h. Although the difference was insignificant, the liver effluent enzyme levels in the HMP group were lower than those in the CS group. Furthermore, morphological findings showed fewer injured hepatocytes in the HMP group than in the CS group. The combined use of in situ subnormothermic ECMO and HMP was beneficial for the functional improvement of DCD liver grafts. MDPI 2023-09-18 /pmc/articles/PMC10532259/ /pubmed/37762971 http://dx.doi.org/10.3390/jcm12186031 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Iwata, Hiroyoshi
Obara, Hiromichi
Nakajo, Tetsuya
Kaneko, Hiroki
Okazawa, Yuga
Mohd Zin, Nur Khatijah
Bochimoto, Hiroki
Ohashi, Makito
Kawada, Yoko
Ohara, Mizuho
Yokoo, Hideki
Matsuno, Naoto
Beneficial Effects of Combined Use of Extracorporeal Membrane Oxygenation and Hypothermic Machine Perfusion in Porcine Donors after Cardiac Death for Liver Transplantation
title Beneficial Effects of Combined Use of Extracorporeal Membrane Oxygenation and Hypothermic Machine Perfusion in Porcine Donors after Cardiac Death for Liver Transplantation
title_full Beneficial Effects of Combined Use of Extracorporeal Membrane Oxygenation and Hypothermic Machine Perfusion in Porcine Donors after Cardiac Death for Liver Transplantation
title_fullStr Beneficial Effects of Combined Use of Extracorporeal Membrane Oxygenation and Hypothermic Machine Perfusion in Porcine Donors after Cardiac Death for Liver Transplantation
title_full_unstemmed Beneficial Effects of Combined Use of Extracorporeal Membrane Oxygenation and Hypothermic Machine Perfusion in Porcine Donors after Cardiac Death for Liver Transplantation
title_short Beneficial Effects of Combined Use of Extracorporeal Membrane Oxygenation and Hypothermic Machine Perfusion in Porcine Donors after Cardiac Death for Liver Transplantation
title_sort beneficial effects of combined use of extracorporeal membrane oxygenation and hypothermic machine perfusion in porcine donors after cardiac death for liver transplantation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10532259/
https://www.ncbi.nlm.nih.gov/pubmed/37762971
http://dx.doi.org/10.3390/jcm12186031
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