TY - JOUR
T1 - Normothermic extracorporeal perfusion of isolated porcine liver after warm ischaemia
T2 - A preliminary report
AU - Bellomo, Rinaldo
AU - Suzuki, Satoshi
AU - Marino, Bruno
AU - Starkey, Graeme K.
AU - Chambers, Brenton
AU - Fink, Michael A.
AU - Wang, Bao Zhong
AU - Houston, Shane
AU - Eastwood, Glenn
AU - Calzavacca, Paolo
AU - Glassford, Neil
AU - Skene, Alison
AU - Jones, Daryl A.
AU - Jones, Robert
PY - 2012/12/1
Y1 - 2012/12/1
N2 - Liver transplantation is a major life-saving procedure, and donation after cardiac death (DCD) has increased the pool of potential liver donors. However, DCD livers are at increased risk of primary graft dysfunction and biliary tract ischaemia. Normothermic extracorporeal liver perfusion (NELP) may increase the ability to protect, evaluate and, in future, transplant DCD livers. We conducted proof-of-concept experiments using a DCD model in the pig to assess the short-term (4 hours) feasibility and functional efficacy of NELP. Using extracorporeal membrane oxygenation, parenteral nutrition, separate hepatic artery and portal vein perfusion, and physiological perfusion pressures, we achieved NELP and evidence of function (bile production, paracetamol removal, maintenance of normal ammonia and lactate levels) for 4 hours in pig livers subjected to 15 and 30 minutes of cardiac arrest before explantation. Our experiments justify further investigations of the feasibility and efficacy of human DCD liver preservation by ex-vivo perfusion.
AB - Liver transplantation is a major life-saving procedure, and donation after cardiac death (DCD) has increased the pool of potential liver donors. However, DCD livers are at increased risk of primary graft dysfunction and biliary tract ischaemia. Normothermic extracorporeal liver perfusion (NELP) may increase the ability to protect, evaluate and, in future, transplant DCD livers. We conducted proof-of-concept experiments using a DCD model in the pig to assess the short-term (4 hours) feasibility and functional efficacy of NELP. Using extracorporeal membrane oxygenation, parenteral nutrition, separate hepatic artery and portal vein perfusion, and physiological perfusion pressures, we achieved NELP and evidence of function (bile production, paracetamol removal, maintenance of normal ammonia and lactate levels) for 4 hours in pig livers subjected to 15 and 30 minutes of cardiac arrest before explantation. Our experiments justify further investigations of the feasibility and efficacy of human DCD liver preservation by ex-vivo perfusion.
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M3 - Article
C2 - 22963210
AN - SCOPUS:84868229874
SN - 1441-2772
VL - 14
SP - 173
EP - 176
JO - Critical Care and Resuscitation
JF - Critical Care and Resuscitation
IS - 3
ER -