The Effects of Preservation Temperature During Machine Perfusion Preservation for Porcine Liver Donated after Cardiac Death Evaluated by Isolated Liver Perfusion Model
Mikako Gochi1, Naoto Matsuno1,2, Hiromichi Obara3, Yo Ishihara1, Tatsuya Shonaka1, Masahide Otani1,2, Mizuho Ohara1, Hiroyuki Takahashi1, Yuji Nishikawa4, Hiroyuki Furukawa1.
1Gastroenterology and Transplantation, Asahikawa Medical University, Asahikawa, Japan; 2Transplantation technology, Asahikawa Medical University, Asahikawa, Japan; 3Mechanical Engineering, Metropolitan University of Tokyo, Tokyo, Japan; 4Pathology, Asahikawa Medical University, Asahikawa, Japan
Background:Because of difficulty of evaluation for the graft function during perfusion preservation, ex vivo isolated liver perfusion model was developed and assessed DCD liver graft at different preservation temperature. Enough number of animal are necessary to conduct detailed experiment
to evaluate preservation results. And also reduction and replacement of animal experiments should
be considering to design experiments. In this study, ex vivo perfusion model using autologous.
blood under normothermic perfusion condition was established to evaluate availability of machine
preservation for liver donated after cardiac death (DCD). In particular, results of the subnormothermic
machine perfusion for DCD porcine livers were evaluated using ex vivo reperfusion model.
Materials and Methods:Porcine liver grafts were procured under warm ischemia time of 60 minutes
imitated the DCD graft condition. The liver grafts were preserved under three conditions for 4 hours
Group 1; liver grafts were preserved with simple cold storage (CS)(n=3); Group 2; grafts were
perfused with hypothermic machine preservation(HMP)with a modified university of Wisconsin
solution(n=3); Group3; liver grafts were perfused with subnormothermic machine perfusion
(SMP)(n=3) Preserved grafts were perfused with autologous blood at 37°C for 2 hours to access
the organ functions. The vascular pressures, the oxygen consumption and enzyme release rate of
AST and LDH during reperfusion were analyzed.
Results:Vascular resistance of portal vein and hepatic artery after reperfusion were remarkably
higher in Group 3 compared than Group 2 and 3. In addition, portal and hepatic artery resistance
in early phase was more higher in Group 2 rather than Group 3 AST, LDH , ALP and hyaluronic
acid were remarkably higher in Group 1 rather than Group 2 and 3.(P<0.05) The changes of AST
and LDH at 0 ~30min after reperfusion was lower in Group 3 Historical findings showed severe
hepatocyte necrosis in Group 1 rather than Group 2.
Conclusions:In summary, this study demonstrates that ex vivo isolated reperfusion model has
possibility of applying to evaluate for liver graft function.
