TransplantationNormothermic extracorporeal liver perfusion for donation after cardiac death (DCD) livers
Section snippets
Animals
Twelve female land race/farm pigs (30–34 kg) were purchased from Oak Hill Genetics, IL. All animals were housed and maintained in accordance with the National Resource Council guidelines. All experimental procedures and protocols were approved by the Animal Studies committee and Department of Comparative Medicine at the Washington University School of Medicine in St Louis. They were given access to food and water ad libitum and were restricted from solid food but not water 12 hours before the
NELP reduces hepatocyte injury of DCD livers compared with grafts preserved in cold storage
To evaluate the efficacy of NELP in recovering DCD livers, livers were subjected to warm ischemia and then either placed on NELP or maintained in cold storage for 6 hours. Livers from both groups were then placed onto NELP for a final 2-hour period to simulate posttransplant conditions in which measurements of the liver physiologic function were collected. We measured liver enzymes as markers of liver injury and necrosis.
In the first set of experiments, we evaluated graft function, degree of
Discussion
In this study, we for the first time compared outcomes of warm perfusion and cold preservation of the liver during a functional reperfusion period. We demonstrate that normothermic perfusion has the potential to recover and stabilize warm ischemic injured livers by providing full metabolic support and oxygenation to the liver tissue by re-establishing physiologic flows and parameters. Prior studies have shown the feasibility of NELP by comparing standard cold storage to NELP after warm
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This project was funded by the Barnes Jewish Hospital Foundation Project Award, Transplant Research Support.