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Association of Perfusion Characteristics and Posttransplant Liver Function in Ischemia‐Free Liver Transplantation
Author(s) -
Zhang Zhiheng,
Tang Yunhua,
Zhao Qiang,
Wang Linhe,
Zhu Caihui,
Ju Weiqiang,
Wang Dongping,
Yang Lu,
Wu Linwei,
Chen Maogen,
Huang Shanzhou,
Gao Ningxin,
Zhu Zebin,
Zhang Yixi,
Sun Chengjun,
Xiong Wei,
Shen Yuekun,
Ma Yi,
Hu Anbin,
Zhu Xiaofeng,
Rong Jian,
Cai Changjie,
Guo Zhiyong,
He Xiaoshun
Publication year - 2020
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.25825
Subject(s) - medicine , liver transplantation , perfusion , machine perfusion , transplantation , liver function , liver function tests , aspartate transaminase , ischemia , transaminase , alanine transaminase , artery , cardiology , surgery , alkaline phosphatase , biology , biochemistry , enzyme
It has been shown that normothermic machine perfusion (NMP), a novel preservation method, is able to assess and resuscitate liver grafts with risk factors. However, there is no consistent criteria for the assessment of liver grafts with NMP. Ischemia‐free liver transplantation (IFLT) includes innovative surgical techniques and NMP, which can protect liver grafts from ischemia throughout organ procurement, preservation, and implantation. In our center, 28 human livers from donation after brain death donors were subjected to IFLT between July 2017 and October 2018. The correlation between posttransplant liver function tests with the perfusion parameters, blood gas analysis of perfusate, and bile biochemistry were analyzed. During the preservation phase, the vascular flow was stable, and the lactate level decreased rapidly. The transaminase release in the perfusate was low but stable, whereas the glucose level remained high. The perfusate lactate and aspartate aminotransferase (AST) levels at 1 hour of perfusion were correlated with the posttransplant peak AST level. There were negative correlations between the portal vein and hepatic artery flows at the end of perfusion and the peak transaminase levels within 7 days after transplantation. In conclusion, during IFLT, NMP is able to bridge the liver grafts from donors to recipients and can allow the assessment of liver function by perfusion characteristics.