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Oxygenated hypothermic machine perfusion after static cold storage improves endothelial function of extended criteria donor livers.
- Source :
-
HPB : the official journal of the International Hepato Pancreato Biliary Association [HPB (Oxford)] 2017 Jun; Vol. 19 (6), pp. 538-546. Date of Electronic Publication: 2017 Mar 25. - Publication Year :
- 2017
-
Abstract
- Background: Lack of oxygen and biomechanical stimulation during static cold storage (SCS) of donor livers compromises endothelial cell function. We investigated the effect of end-ischemic oxygenated hypothermic machine perfusion (HMP) on endothelial cell function of extended criteria donor (ECD) livers.<br />Methods: Eighteen livers, declined for transplantation, were transported to our center using static cold storage (SCS). After SCS, 6 livers underwent two hours of HMP, and subsequent normothermic machine perfusion (NMP) to assess viability. Twelve control livers underwent NMP immediately after SCS. mRNA expression of transcription factor Krüppel-like-factor 2 (KLF2), endothelial nitric oxide synthase (eNOS), and thrombomodulin (TM) was quantified by RT-PCR. Endothelial cell function and injury were assessed by nitric oxide (NO) production and release of TM into the perfusate.<br />Results: In HMP livers, mRNA expression of KLF2 (p = 0.043), eNOS (p = 0.028), and TM (p = 0.028) increased significantly during NMP. In parallel, NO levels increased during NMP in HMP livers but not in controls. At the end of NMP cumulative TM release was significantly lower HMP livers, compared to controls (p = 0.028).<br />Conclusion: A short period of two hours oxygenated HMP restores endothelial cell viability after SCS and subsequent normothermic reoxygenation of ECD livers.<br /> (Copyright © 2017 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.)
- Subjects :
- Aged
Cell Survival
Donor Selection
Endothelial Cells pathology
Female
Gene Expression Regulation
Humans
Kruppel-Like Transcription Factors genetics
Kruppel-Like Transcription Factors metabolism
Liver metabolism
Liver pathology
Liver Transplantation adverse effects
Male
Middle Aged
Netherlands
Nitric Oxide metabolism
Nitric Oxide Synthase Type III genetics
Nitric Oxide Synthase Type III metabolism
Organ Preservation adverse effects
Organ Preservation instrumentation
Perfusion adverse effects
Perfusion instrumentation
RNA, Messenger genetics
RNA, Messenger metabolism
Thrombomodulin genetics
Thrombomodulin metabolism
Time Factors
Cold Temperature
Endothelial Cells metabolism
Hepatectomy adverse effects
Liver surgery
Liver Transplantation methods
Organ Preservation methods
Oxygen metabolism
Perfusion methods
Tissue Donors supply & distribution
Subjects
Details
- Language :
- English
- ISSN :
- 1477-2574
- Volume :
- 19
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- HPB : the official journal of the International Hepato Pancreato Biliary Association
- Publication Type :
- Academic Journal
- Accession number :
- 28351756
- Full Text :
- https://doi.org/10.1016/j.hpb.2017.02.439