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Determination and Extension of the Limits to Static Cold Storage using Subnormothermic Machine Perfusion

Authors :
Bruinsma, Bote G.
Berendsen, Tim A.
Izamis, Maria-Louisa
Yarmush, Martin L.
Uygun, Korkut
Source :
International Journal of Artificial Organs; November 2013, Vol. 36 Issue: 11 p775-780, 6p
Publication Year :
2013

Abstract

Background/Aims Static cold storage (SCS) of the liver for transplantation is limited by time. Continuation of metabolic activity leads to depletion of energy stores and loss of cellular function, which results in poor post-transplant function. Machine perfusion (MP) applied at the end of preservation may improve the viability of marginal liver grafts and provides information on the quality of the organ. We attempt to define the limits to SCS in terms of easily measurable perfusion parameters and investigate whether MP can improve liver viability.Methods Rat livers were cold-stored for 0, 24, 48, 72, and 120 h, after which they were treated with subnormothermic machine perfusion (SNMP). Livers cold-stored for 48 and 72 h were transplanted orthotopically with or without SNMP. During SNMP easily measurable parameters were monitored and adenosine triphosphate (ATP) content was measured following preservation and SNMP.Results ATP increased significantly during SNMP, but the recovered ATP content deteriorated with increased duration of SCS, with minimal improvement after 72 h of SCS. Vascular resistance during SNMP increased with extended preservation. After 48 h of SCS, orthotopic transplantation survival increased significantly from 50% to 100% with SNMP, but did not improve after 72 h.MConclusions Vascular resistance and ATP recovery suggest a decrease in viability after 48 h of SCS. Survival data confirms the loss of post-transplant graft function and supports the use of ATP and vascular resistance as useful indicators. Further, we show that the recoverability of a liver using SNMP is limited to 48 h of SCS.

Details

Language :
English
ISSN :
03913988 and 17246040
Volume :
36
Issue :
11
Database :
Supplemental Index
Journal :
International Journal of Artificial Organs
Publication Type :
Periodical
Accession number :
ejs44633113
Full Text :
https://doi.org/10.5301/ijao.5000250