Document Detail


Hypothermic machine preservation in liver transplantation revisited: concepts and criteria in the new millennium.
MedLine Citation:
PMID:  15117035     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To overcome the present shortage of liver donors by expansion of the existing donor pool and possibly lengthening of the storage time, hypothermic machine perfusion of the liver as a dynamic preservation method is revisited. The three most important aspects are defined to be the type of preservation solution, the characteristics of perfusion dynamics, and the oxygen supply. Reviewing hypothermic liver machine perfusion experiments, the University of Wisconsin machine preservation solution is the solution most used. It is also found that nothing conclusive can be said about the optimal perfusion characteristics, since either perfusion pressure or perfusion flow is reported. The best estimation is perfusion of the liver in a physiological manner, i.e. pulsatile arterial perfusion and continuous portal venous perfusion. The applied pressures could be chosen to be somewhat lower than physiological pressures to prevent possible endothelial cell damage. Oxygen supply is necessary to achieve optimal preservation of the liver. The minimal amount of partial oxygen pressure required is inversely related to the normalized flow. Incorporating these features in a system based on existing standard surgical and organ sharing procedures and which is able to work stand-alone for 24 h, weighing less than 23 kg, could successfully implement this technique into every day clinical practise.
Authors:
Arjan van der Plaats; Nils A 't Hart; Gijsbertus J Verkerke; Henri G D Leuvenink; Rutger J Ploeg; Gerhard Rakhorst
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Annals of biomedical engineering     Volume:  32     ISSN:  0090-6964     ISO Abbreviation:  Ann Biomed Eng     Publication Date:  2004 Apr 
Date Detail:
Created Date:  2004-04-30     Completed Date:  2004-11-12     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0361512     Medline TA:  Ann Biomed Eng     Country:  United States    
Other Details:
Languages:  eng     Pagination:  623-31     Citation Subset:  IM    
Affiliation:
Department of BioMedical Engineering, University of Groningen, Ant. Deusinglaan 1, 9713 AV Groningen, The Netherlands. a.van.der.plaats@med.rug.nl
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MeSH Terms
Descriptor/Qualifier:
Cryopreservation / instrumentation,  methods*
Humans
Liver
Liver Transplantation*
Oxygen / physiology
Perfusion / instrumentation,  methods*
Quality Control
Tissue Donors
Chemical
Reg. No./Substance:
7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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