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Applicability of Hypothermic Oxygenate Machine Perfusion Preservation for Split-Liver Transplantation in a Porcine Model: An Experimental Study

BACKGROUND: Split-liver transplantation can be useful in situations of limited donor resources. However, novel preservation methods are required to help the recipient recover from severe ischemic reperfusion injury incurred due to receiving a relatively small liver graft. MATERIAL/METHODS: Our exper...

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Autores principales: Ishii, Daisuke, Matsuno, Naoto, Gochi, Mikako, Otani, Masahide, Shonaka, Tatsuya, Takahashi, Hiroyuki, Nishikawa, Yuji, Yoshikawa, Ryo, Obara, Hiromichi, Miyamoto, Kazutoshi, Furukawa, Hiroyuki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6978992/
https://www.ncbi.nlm.nih.gov/pubmed/31932575
http://dx.doi.org/10.12659/AOT.919920
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author Ishii, Daisuke
Matsuno, Naoto
Gochi, Mikako
Otani, Masahide
Shonaka, Tatsuya
Takahashi, Hiroyuki
Nishikawa, Yuji
Yoshikawa, Ryo
Obara, Hiromichi
Miyamoto, Kazutoshi
Furukawa, Hiroyuki
author_facet Ishii, Daisuke
Matsuno, Naoto
Gochi, Mikako
Otani, Masahide
Shonaka, Tatsuya
Takahashi, Hiroyuki
Nishikawa, Yuji
Yoshikawa, Ryo
Obara, Hiromichi
Miyamoto, Kazutoshi
Furukawa, Hiroyuki
author_sort Ishii, Daisuke
collection PubMed
description BACKGROUND: Split-liver transplantation can be useful in situations of limited donor resources. However, novel preservation methods are required to help the recipient recover from severe ischemic reperfusion injury incurred due to receiving a relatively small liver graft. MATERIAL/METHODS: Our experiment was performed using porcine livers without warm ischemia time, assuming a brain-dead organ. We made porcine split-liver grafts by 75% liver resection at the back table and divided the specimens into 4 groups. Group 1 was preserved with simple cold storage after splitting (CS; n=3), Group 2 was preserved with hypothermic perfusion preservation (HMP) after splitting (SBP; n=3), Group 3 was preserved with HMP after splitting under perfusion preservation (SDP; n=4), and Group 4 had the whole liver perfused as control grafts (Whole Liver; n=3). To assess potential methods of preservation and their effects, all grafts were evaluated by an ex vivo isolated liver reperfusion model using diluted autologous blood. RESULTS: Portal vein pressure resistances during reperfusion were low in Group3 (SDP). Hepatic artery pressure resistances during reperfusion were markedly higher in Group 1(CS) than in the other groups. The levels of AST and LDH were high and increased at 2 h after reperfusion in Group 1 (CS). The histological findings show that the liver cell structure was irregular in Group 1 (CS) but remained regular in Groups 2 (SBP) and 3 (SDP). Histological Suzuki scores were also significantly better in Groups 2 (SBP) and 3 (SDP) compared with Group 1 (CS). CONCLUSIONS: Splitting the liver under machine perfusion preservation may help restore the function and reduce ischemia-reperfusion injury.
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spelling pubmed-69789922020-03-04 Applicability of Hypothermic Oxygenate Machine Perfusion Preservation for Split-Liver Transplantation in a Porcine Model: An Experimental Study Ishii, Daisuke Matsuno, Naoto Gochi, Mikako Otani, Masahide Shonaka, Tatsuya Takahashi, Hiroyuki Nishikawa, Yuji Yoshikawa, Ryo Obara, Hiromichi Miyamoto, Kazutoshi Furukawa, Hiroyuki Ann Transplant Original Paper BACKGROUND: Split-liver transplantation can be useful in situations of limited donor resources. However, novel preservation methods are required to help the recipient recover from severe ischemic reperfusion injury incurred due to receiving a relatively small liver graft. MATERIAL/METHODS: Our experiment was performed using porcine livers without warm ischemia time, assuming a brain-dead organ. We made porcine split-liver grafts by 75% liver resection at the back table and divided the specimens into 4 groups. Group 1 was preserved with simple cold storage after splitting (CS; n=3), Group 2 was preserved with hypothermic perfusion preservation (HMP) after splitting (SBP; n=3), Group 3 was preserved with HMP after splitting under perfusion preservation (SDP; n=4), and Group 4 had the whole liver perfused as control grafts (Whole Liver; n=3). To assess potential methods of preservation and their effects, all grafts were evaluated by an ex vivo isolated liver reperfusion model using diluted autologous blood. RESULTS: Portal vein pressure resistances during reperfusion were low in Group3 (SDP). Hepatic artery pressure resistances during reperfusion were markedly higher in Group 1(CS) than in the other groups. The levels of AST and LDH were high and increased at 2 h after reperfusion in Group 1 (CS). The histological findings show that the liver cell structure was irregular in Group 1 (CS) but remained regular in Groups 2 (SBP) and 3 (SDP). Histological Suzuki scores were also significantly better in Groups 2 (SBP) and 3 (SDP) compared with Group 1 (CS). CONCLUSIONS: Splitting the liver under machine perfusion preservation may help restore the function and reduce ischemia-reperfusion injury. International Scientific Literature, Inc. 2020-01-14 /pmc/articles/PMC6978992/ /pubmed/31932575 http://dx.doi.org/10.12659/AOT.919920 Text en © Ann Transplant, 2020 This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) )
spellingShingle Original Paper
Ishii, Daisuke
Matsuno, Naoto
Gochi, Mikako
Otani, Masahide
Shonaka, Tatsuya
Takahashi, Hiroyuki
Nishikawa, Yuji
Yoshikawa, Ryo
Obara, Hiromichi
Miyamoto, Kazutoshi
Furukawa, Hiroyuki
Applicability of Hypothermic Oxygenate Machine Perfusion Preservation for Split-Liver Transplantation in a Porcine Model: An Experimental Study
title Applicability of Hypothermic Oxygenate Machine Perfusion Preservation for Split-Liver Transplantation in a Porcine Model: An Experimental Study
title_full Applicability of Hypothermic Oxygenate Machine Perfusion Preservation for Split-Liver Transplantation in a Porcine Model: An Experimental Study
title_fullStr Applicability of Hypothermic Oxygenate Machine Perfusion Preservation for Split-Liver Transplantation in a Porcine Model: An Experimental Study
title_full_unstemmed Applicability of Hypothermic Oxygenate Machine Perfusion Preservation for Split-Liver Transplantation in a Porcine Model: An Experimental Study
title_short Applicability of Hypothermic Oxygenate Machine Perfusion Preservation for Split-Liver Transplantation in a Porcine Model: An Experimental Study
title_sort applicability of hypothermic oxygenate machine perfusion preservation for split-liver transplantation in a porcine model: an experimental study
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6978992/
https://www.ncbi.nlm.nih.gov/pubmed/31932575
http://dx.doi.org/10.12659/AOT.919920
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