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Protective role of normothermic machine perfusion during reduced‐size liver transplantation in pigs
Author(s) -
Zhang ZhiBin,
Gao Wei,
Shi Yuan,
Liu Lei,
Ma Ning,
Chen Jing,
Zhu ZhiJun
Publication year - 2016
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.24453
Subject(s) - medicine , liver transplantation , machine perfusion , viaspan , perfusion , lactate dehydrogenase , cold storage , transplantation , ischemia , warm ischemia , urology , surgery , reperfusion injury , gastroenterology , biochemistry , biology , horticulture , enzyme
The purpose of this study is to explore whether normothermic machine perfusion (NMP) preservation is superior to cold preservation during reduced‐size liver transplantation (RSLT) in pigs. Twenty‐four healthy Ba‐Ma mini pigs were used (aged >13 months; weight 25‐35 kg; regardless of sex). The animals were randomized into 2 groups. In group A (NMP), donor livers were harvested without warm ischemia time and heartbeats and then were connected to the NMP system to reduce the livers' size under the normothermic condition. In group B (University of Wisconsin [UW] solution), donor livers were harvested without warm ischemia time and heartbeats after being perfused by UW solution and were then preserved in 0°C‐4°C UW solution to reduce the livers' size under cold conditions. After that, liver transplantation without venovenous bypass was performed. General RSLT information of the pigs from the 2 groups was recorded; the serological indices were measured; and routine pathological examination of liver tissue was observed. A significant difference was observed in the intraoperative bleeding between the 2 groups ( P < 0.05), whereas no significant difference was found in the other indices (all P > 0.05). Significant differences of alanine aminotransferase levels, aspartate aminotransferase levels, and lactate dehydrogenase levels between the 2 groups were observed between postoperative days 3 and 5 ( P < 0.05). Significant differences of lactic acid levels between the 2 groups were observed between postoperative days 2 and 5 ( P < 0.05). Compared with the cold preservation group, the liver tissues of the NMP preservation group only rarely experienced liver cell necrosis and maintained integrities in the hepatic sinusoid spaces and endothelial cells. In conclusion, NMP preservation is superior to cold preservation during RSLT in pigs. Liver Transplantation 22 968–978 2016 AASLD