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A novel oxygenated machine perfusion system for preservation of the liver

机译：一种用于保护肝脏的新型加氧机灌注系统

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Machine perfusion (MP) is a potential method to increase the donor pool for organ transplantation. However, MP systems for liver grafts remain difficult to use because of organ-specific demands. Our aim was to test a novel, portable MP system for hypothermic preservation of the liver. A portable, pressure-regulated, oxygenated MP system designed for kidney preservation was adapted to perfuse liver grafts via the portal vein (PV). Three porcine livers underwent 20h of hypothermic perfusion using Belzer MP solution. The MP system was assessed for perfusate flow, temperature, venous pressure, and pO2/pCO2 during the preservation period. Biochemical and histological parameters were analyzed to determine postpreservation organ damage. Perfusate flow through the PV increased over time from 157±25mL/min at start to 177±25mL/min after 20h. PV pressure remained stable at 13±1mmHg. Perfusate temperature increased from 9.7±0.6°C at the start to 11.0±0.0°C after 20h. Aspartate aminotransferase and lactate dehydrogenase increased from 281±158 and 308±171U/L after 1h to 524±163 and 537±168U/L after 20h, respectively. Blood gas analysis showed a stable pO2 of 338±20mmHg before perfusion of the liver and 125±14mmHg after 1h perfusion. The pCO2 increased from 15±5mmHg after 1h to 53±4mmHg after 20h. No histological changes were found after 20h of MP. This study demonstrated the feasibility of a portable MP system for preservation of the liver and showed that continuous perfusion via the PV can be maintained with an oxygen-driven pump system without notable preservation damage of the organ.
机译：机器灌注（MP）是增加器官移植供体池的一种潜在方法。然而，由于器官的特定需求，用于肝脏移植物的MP系统仍然难以使用。我们的目标是测试一种新型的便携式MP系统，以对肝脏进行低温保存。设计用于肾脏保存的便携式，压力调节，氧化的MP系统适用于通过门静脉（PV）灌注肝移植物。使用Belzer MP溶液对三个猪肝进行20h低温灌注。在保存期间，对MP系统的灌注液流量，温度，静脉压力和pO2 / pCO2进行了评估。分析生化和组织学参数以确定保存后器官的损伤。通过PV的灌注液流量随时间从开始时的157±25mL / min增加到20小时后的177±25mL / min。 PV压力保持稳定在13±1mmHg。灌注液温度从开始时的9.7±0.6°C升高到20小时后的11.0±0.0°C。天门冬氨酸转氨酶和乳酸脱氢酶分别从1小时后的281±158和308±171U / L增加到20小时后的524±163和537±168U / L。血气分析显示，肝脏灌注前的pO2稳定在338±20mmHg，灌注1h后稳定在125±14mmHg。 pCO2从1小时后的15±5mmHg增加到20小时后的53±4mmHg。 MP 20h后未发现组织学变化。这项研究证明了便携式MP系统用于肝脏保藏的可行性，并表明可以通过氧气驱动的泵系统维持通过PV的连续灌注，而不会显着损害器官。

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