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The Use of an Acellular Oxygen Carrier in a Human Liver Model of Normothermic Machine Perfusion.
- Source :
-
Transplantation [Transplantation] 2017 Nov; Vol. 101 (11), pp. 2746-2756. - Publication Year :
- 2017
-
Abstract
- Background: Normothermic machine perfusion of the liver (NMP-L) is a novel technique that preserves liver grafts under near-physiological conditions while maintaining their normal metabolic activity. This process requires an adequate oxygen supply, typically delivered by packed red blood cells (RBC). We present the first experience using an acellular hemoglobin-based oxygen carrier (HBOC) Hemopure in a human model of NMP-L.<br />Methods: Five discarded high-risk human livers were perfused with HBOC-based perfusion fluid and matched to 5 RBC-perfused livers. Perfusion parameters, oxygen extraction, metabolic activity, and histological features were compared during 6 hours of NMP-L. The cytotoxicity of Hemopure was also tested on human hepatic primary cell line cultures using an in vitro model of ischemia reperfusion injury.<br />Results: The vascular flow parameters and the perfusate lactate clearance were similar in both groups. The HBOC-perfused livers extracted more oxygen than those perfused with RBCs (O2 extraction ratio 13.75 vs 9.43 % ×10 per gram of tissue, P = 0.001). In vitro exposure to Hemopure did not alter intracellular levels of reactive oxygen species, and there was no increase in apoptosis or necrosis observed in any of the tested cell lines. Histological findings were comparable between groups. There was no evidence of histological damage caused by Hemopure.<br />Conclusions: Hemopure can be used as an alternative oxygen carrier to packed red cells in NMP-L perfusion fluid.
- Subjects :
- Adult
Aged
Apoptosis
Blood Substitutes toxicity
Cells, Cultured
Energy Metabolism drug effects
Female
Hemoglobins toxicity
Hepatectomy
Humans
Liver metabolism
Liver pathology
Liver surgery
Male
Middle Aged
Necrosis
Organ Preservation adverse effects
Oxygen Consumption drug effects
Perfusion adverse effects
Reactive Oxygen Species metabolism
Reperfusion Injury etiology
Reperfusion Injury metabolism
Reperfusion Injury pathology
Time Factors
Tissue Survival drug effects
Blood Substitutes pharmacology
Hemoglobins pharmacology
Liver drug effects
Organ Preservation methods
Perfusion methods
Reperfusion Injury prevention & control
Subjects
Details
- Language :
- English
- ISSN :
- 1534-6080
- Volume :
- 101
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 28520579
- Full Text :
- https://doi.org/10.1097/TP.0000000000001821