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Influence of extracorporeal porcine liver perfusion on nonhuman primates: Minimizing hemolysis improves subsequent survival
Author(s) -
Nishitai Ryuta,
Ikai Iwao,
Terajima Hiroaki,
Kanazawa Akiyoshi,
Takeyama Osamu,
Uesugi Takehiko,
Okabe Hiroshi,
Katsura Nagato,
Matsushita Takakazu,
Yamanokuchi Satoshi,
Matsuo Koichi,
Sugimoto Shinichi,
Shiotani Tomohiro,
Yamaoka Yoshio
Publication year - 2001
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 - 10.1053/jlts.2001.25362
Subject(s) - baboon , medicine , hemolysis , perfusion , extracorporeal circulation , extracorporeal , gastroenterology , cardiology
The aim of this study is to detect and analyze risk factors of direct cross‐circulation between porcine liver and nonhuman primates before a clinical application of extracorporeal liver perfusion (ECLP) as a liver‐assist method. Porcine livers were perfused with baboon blood in an ECLP system. Six healthy baboons were directly connected to the ECLP system with continuous prostaglandin E 1 administration. Cross‐circulation was terminated in the following circumstances: (1) hepatic arterial or portal perfusion pressures elevated to 200 or 60 mm Hg, respectively; (2) massive exudative bleeding from the graft surface; or (3) bile output decreased to less than 5 μL/h/g of liver weight. In case 1, cross‐circulation was continued for 10 hours. Severe macroscopic hemolysis occurred, and serum hemoglobin (s‐Hb) concentration reached a peak of 47 mg/dL. The baboon died of acute renal failure 2 days later. Histological study of the perfused porcine liver showed marked microthrombi formation. In 3 of the later 5 cases, cross‐circulation was discontinued when mild macroscopic hemolysis was observed. The duration of the 5 cross‐circulations was maximally 6 hours (mean, 4.4 ± 1.2 [SD] hours). Mean s‐Hb concentration in the 5 cases was elevated to 14.8 ± 5.8 mg/dL at the end of cross‐circulation and decreased to the baseline level within 24 hours. These 5 baboons survived without organ dysfunction or immunologic disturbance. When severe hemolysis is avoided, direct cross‐circulation using the ECLP system can be achieved without serious complications in nonhuman primates.