Document Detail


Preservation of porcine non-heart-beating donor livers by sequential cold storage and warm perfusion.
MedLine Citation:
PMID:  15167586     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Normothermic perfusion has been shown to resuscitate and maintain viability of non-heart-beating donor (NHBD) livers that have undergone significant warm ischemic injury. However, the logistics of clinical organ retrieval are complex, and a period of cold storage before warm preservation would simplify the process. We have investigated the effects of short duration of cold preservation before normothermic preservation on the function of porcine NHBD livers. METHODS: Porcine livers were subjected to 60 minutes of warm ischemia and then assigned to the following groups: group W (n=5), normothermic preservation for 24 hours; and group C (n=4), cold preservation in University of Wisconsin solution for 4 hours followed by normothermic preservation for 20 hours (total preservation time 24 hours). Outcome parameters that were measured included bile production, serum transaminases and hyaluronic acid levels (cellular damage), and base deficit and glucose use (metabolic function). RESULTS: Group W livers had superior bile production, metabolic activity (base deficit and greater glucose use), and less evidence of hepatocellular damage (alanine aminotransferase, aspartate aminotransferase), and sinusoidal endothelial cell dysfunction (hyaluronic acid). Group C livers showed greater necrosis and destruction of architecture on histology. CONCLUSION: Normothermic perfusion failed to resuscitate porcine livers after 60 minutes of warm ischemia and 4 hours of cold preservation. Even a short period of cold ischemia is significantly deleterious to the function of ischemically damaged (NHBD) livers.
Authors:
Srikanth P Reddy; Shantanu Bhattacharjya; Nikolai Maniakin; Joanne Greenwood; Dino Guerreiro; David Hughes; Charles J Imber; David W Pigott; Susan Fuggle; Richard Taylor; Peter J Friend
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Transplantation     Volume:  77     ISSN:  0041-1337     ISO Abbreviation:  Transplantation     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-05-28     Completed Date:  2004-06-22     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0132144     Medline TA:  Transplantation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1328-32     Citation Subset:  IM    
Affiliation:
Nuffield Department of Surgery, University of Oxford, Oxford, UK.
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MeSH Terms
Descriptor/Qualifier:
Acid-Base Equilibrium
Animals
Bile / metabolism
Cold Temperature*
Factor V / metabolism
Graft Survival
Heart Arrest
Hot Temperature
Ischemia / metabolism,  pathology*
Liver / metabolism,  pathology*,  surgery
Liver Transplantation*
Organ Preservation / methods*
Perfusion
Sus scrofa
Tissue Donors
Chemical
Reg. No./Substance:
9001-24-5/Factor V

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


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