Effects of Subnormothermic Perfusion Before Transplantation for Liver Grafts from Donation After Cardiac Death: A Simplified Dripping Perfusion Method in Pigs

Y. Kakizaki, S. Miyagi, Kenji Shimizu, H. Kumata, M. Matsumura, Yuki Miyazaki, K. Fukuoka, S. S. Uematsu, K. Tokodai, Yasuyuki Hara, Chikashi Nakanishi, M. Unno, T. Kamei, M. Goto

研究成果: Article査読

4 被引用数 (Scopus)

抄録

Background: Liver transplantation from donors after cardiac death (DCD) provides a solution to the donor shortage. However, DCD liver grafts are associated with a high incidence of primary graft nonfunction. We investigated the effectiveness of subnormothermic porcine liver perfusion, before transplantation from DCD, on graft viability. Methods: Landrace pigs (25–30 kg) were randomly allocated to 3 groups (5 per group): heart-beating (HB) graft, transplanted after a 4-hour period of cold storage (CS); DCD graft, retrieved 20 minutes after apnea-induced cardiac arrest (respiratory withdrawal) and transplanted after a 4-hour period of CS; and subnormothermic ex vivo liver perfusion (SELP) graft, retrieved in the same manner as the DCD graft but perfused with a subnormothermic oxygenated Krebs-Henseleit buffer (21–25°C, 10–15 cm H2O) for 30 minutes in a simplified dripping manner, without a machine perfusion system, after the 4-hour period of CS, and subsequently transplanted. Results: Although all animals in the HB group survived for >7 days, all animals in the DCD group died within 12 hours after transplantation. In the SELP group, 2 recipients survived for >7 days and another 2 recipients were killed on day 5. The survival rate was significantly better for SELP than for DCD grafts (P =.0016). The values of tumor necrosis factor α were not significantly different between the SELP and HB groups. Preserved structure of the parenchyma was observed in the SELP group on histologic examination. Conclusions: A simplified subnormothermic perfusion before liver transplantation is expected to improve graft viability and survival.

本文言語English
ページ(範囲)1538-1543
ページ数6
ジャーナルTransplantation Proceedings
50
5
DOI
出版ステータスPublished - 2018 6

ASJC Scopus subject areas

  • 外科
  • 移植

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