Document Detail

Hypothermic machine perfusion of the liver and the critical balance between perfusion pressures and endothelial injury.
MedLine Citation:
PMID:  15808634     Owner:  NLM     Status:  MEDLINE    
Hypothermic machine perfusion (HMP) provides better protection against cold ischemic injury than cold storage in marginal donor kidneys. Also, in liver transplantation a switch from static cold storage to HMP could be beneficial as it would allow longer preservation times and the use of marginal donors. A critical question concerning application of HMP in liver preservation is the crucial balance between perfusion pressure and occurrence of endothelial injury. Rat livers were cold-perfused for 24 hours to study perfusion pressures for both hepatic artery and portal vein. Cold storage served as control and was compared to HMP-preserved livers using a mean arterial perfusion pressure of 25 mm Hg and a portal perfusion pressure of 4 mm Hg (25% of normothermic liver circulation) and to HMP at 50 mm Hg and 8 mm Hg perfusion, respectively (50% of normothermic liver circulation). UW solution was enriched with 14.9 micromol/L propidium iodide (PI) to stain for dead cells and with an additional 13.5 micromol/L acridine orange to stain for viable hepatocytes. A low PI-positive cell count was found using HMP at 25% of normal circulation compared to cold storage. The PI count was high for the HMP group perfused at just 50% of normal circulation compared to HMP at 25% and compared to cold storage. In summary, for liver HMP, perfusion at 25% showed complete perfusion with minimal cellular injury. HMP using perfusion pressures of 25 mm Hg for the hepatic artery and 4 mm Hg for the portal vein is feasible without induction of endothelial injury.
N A 't Hart; A van der Plaats; H G D Leuvenink; H van Goor; J Wiersema-Buist; G J Verkerke; G Rakhorst; R J Ploeg
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Transplantation proceedings     Volume:  37     ISSN:  0041-1345     ISO Abbreviation:  Transplant. Proc.     Publication Date:    2005 Jan-Feb
Date Detail:
Created Date:  2005-04-05     Completed Date:  2005-10-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0243532     Medline TA:  Transplant Proc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  332-4     Citation Subset:  IM    
Surgery Research Laboratory, University Hospital Groningen, Groningen, The Netherlands.
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MeSH Terms
Endothelium / pathology*
Hepatic Artery
Hypothermia, Induced*
Liver* / cytology,  pathology,  physiology
Microscopy, Fluorescence
Models, Animal
Organ Preservation / methods*
Rats, Inbred Strains

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