1. Supercooling extends preservation time of human livers
- Author
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Thomas M. van Gulik, Korkut Uygun, Mehmet Toner, Sonal Nagpal, Martin L. Yarmush, Heidi Yeh, James F. Markmann, Sinan Ozer, Peony D. Banik, Stephanie E.J. Cronin, Ehab O A Hafiz, Shannon N. Tessier, Reinier J. de Vries, Graduate School, Surgery, and AGEM - Amsterdam Gastroenterology Endocrinology Metabolism
- Subjects
Organ Preservation Solutions ,Biomedical Engineering ,Bioengineering ,Applied Microbiology and Biotechnology ,03 medical and health sciences ,0302 clinical medicine ,Humans ,Supercooling ,Liver preservation ,030304 developmental biology ,Tissue Survival ,0303 health sciences ,Machine perfusion ,Ice formation ,Chemistry ,Organ Preservation ,Cell biology ,Cold Temperature ,Perfusion ,Transplantation ,Liver ,Homogeneous ,Molecular Medicine ,030217 neurology & neurosurgery ,Ex vivo ,Biotechnology - Abstract
The inability to preserve vascular organs beyond several hours contributes to the scarcity of organs for transplantation1,2. Standard hypothermic preservation at +4 °C (refs. 1,3) limits liver preservation to less than 12 h. Our group previously showed that supercooled ice-free storage at –6 °C can extend viable preservation of rat livers4,5 However, scaling supercooling preservation to human organs is intrinsically limited because of volume-dependent stochastic ice formation. Here, we describe an improved supercooling protocol that averts freezing of human livers by minimizing favorable sites of ice nucleation and homogeneous preconditioning with protective agents during machine perfusion. We show that human livers can be stored at –4 °C with supercooling followed by subnormothermic machine perfusion, effectively extending the ex vivo life of the organ by 27 h. We show that viability of livers before and after supercooling is unchanged, and that after supercooling livers can withstand the stress of simulated transplantation by ex vivo normothermic reperfusion with blood. Preservation of human livers at subzero temperatures with ice-free supercooling extends ex vivo organ life.
- Published
- 2019