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Novel oxygenation technique for hypothermic machine perfusion of liver grafts: Validation in porcine Donation after Cardiac Death (DCD) liver model

Hypothermic oxygenated machine perfusion improves outcomes in Liver Transplantation, but application is limited as O2 is supplied by a stationary circuit. A novel technique of O2 “pre-charge” in a portable pump would broaden use and further mitigate ischemia damage from organ transport. Porcine DCD... Full description

Journal Title: The American journal of surgery 2020-11, Vol.220 (5), p.1270-1277
Main Author: Panayotova, Guergana G
Other Authors: Rosado, Jesus , Paterno, Flavio , Deo, Dayanand , Dikdan, George , McCarty, Matthew A , Arrington, Ben , Giudice, Anthony , Fano, Adam , Dhaduk, Nehal , Lunsford, Keri E , Rao, Prakash , Guarrera, James V
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: United States: Elsevier Inc
ID: ISSN: 0002-9610
Link: https://www.ncbi.nlm.nih.gov/pubmed/32892979
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title: Novel oxygenation technique for hypothermic machine perfusion of liver grafts: Validation in porcine Donation after Cardiac Death (DCD) liver model
format: Article
creator:
  • Panayotova, Guergana G
  • Rosado, Jesus
  • Paterno, Flavio
  • Deo, Dayanand
  • Dikdan, George
  • McCarty, Matthew A
  • Arrington, Ben
  • Giudice, Anthony
  • Fano, Adam
  • Dhaduk, Nehal
  • Lunsford, Keri E
  • Rao, Prakash
  • Guarrera, James V
subjects:
  • Abridged Index Medicus
  • Allografts
  • Analysis
  • Animals
  • Antibodies
  • Biomarkers - metabolism
  • Biopsy
  • Circuits
  • Cold storage
  • Cryopreservation
  • Death
  • Ex vivo perfusion
  • Gene expression
  • Heart
  • Heart transplantation
  • Hypothermic machine perfusion
  • Hypothermic oxygenated machine perfusion
  • Ischemia
  • Ischemia/reperfusion injury
  • Laboratories
  • Liver
  • Liver - metabolism
  • Liver graft preservation
  • Liver Transplantation
  • Methods
  • Models
  • Models, Animal
  • Organ Preservation - methods
  • Oxygen - administration & dosage
  • Oxygenation
  • Perfusion
  • Perfusion - methods
  • Physiological aspects
  • Random Allocation
  • Scavenging
  • Sensors
  • Superoxide dismutase
  • Swine
  • Syngeneic grafts
  • Tissue and Organ Procurement - methods
  • Transplantation
  • Transplants & implants
ispartof: The American journal of surgery, 2020-11, Vol.220 (5), p.1270-1277
description: Hypothermic oxygenated machine perfusion improves outcomes in Liver Transplantation, but application is limited as O2 is supplied by a stationary circuit. A novel technique of O2 “pre-charge” in a portable pump would broaden use and further mitigate ischemia damage from organ transport. Porcine DCD livers were randomized to static cold storage (SCS, n = 8) or hypothermic machine perfusion (HMP). HMP was stratified into HMP-O2 (n = 5), non-O2 open to air HMP-RA (n = 5), and non-O2 with sealed lids or no air HMP-NA (n = 5). HMP-O2 was “pre-charged” using 100% O2 delivered at 10 L/min over 15 min. Perfusate and tissue O2 tension (pO2), liver biopsies, and fluid chemistries were analyzed. “Pre-charge” achieves sustained tissue and perfusate pO2 vs others. HMP-O2 results in decreased markers of hepatocyte injury: ALT (p 
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0002-9610
fulltext: fulltext
issn:
  • 0002-9610
  • 1879-1883
url: Link


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titleNovel oxygenation technique for hypothermic machine perfusion of liver grafts: Validation in porcine Donation after Cardiac Death (DCD) liver model
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creatorPanayotova, Guergana G ; Rosado, Jesus ; Paterno, Flavio ; Deo, Dayanand ; Dikdan, George ; McCarty, Matthew A ; Arrington, Ben ; Giudice, Anthony ; Fano, Adam ; Dhaduk, Nehal ; Lunsford, Keri E ; Rao, Prakash ; Guarrera, James V
creatorcontribPanayotova, Guergana G ; Rosado, Jesus ; Paterno, Flavio ; Deo, Dayanand ; Dikdan, George ; McCarty, Matthew A ; Arrington, Ben ; Giudice, Anthony ; Fano, Adam ; Dhaduk, Nehal ; Lunsford, Keri E ; Rao, Prakash ; Guarrera, James V
descriptionHypothermic oxygenated machine perfusion improves outcomes in Liver Transplantation, but application is limited as O2 is supplied by a stationary circuit. A novel technique of O2 “pre-charge” in a portable pump would broaden use and further mitigate ischemia damage from organ transport. Porcine DCD livers were randomized to static cold storage (SCS, n = 8) or hypothermic machine perfusion (HMP). HMP was stratified into HMP-O2 (n = 5), non-O2 open to air HMP-RA (n = 5), and non-O2 with sealed lids or no air HMP-NA (n = 5). HMP-O2 was “pre-charged” using 100% O2 delivered at 10 L/min over 15 min. Perfusate and tissue O2 tension (pO2), liver biopsies, and fluid chemistries were analyzed. “Pre-charge” achieves sustained tissue and perfusate pO2 vs others. HMP-O2 results in decreased markers of hepatocyte injury: ALT (p < 0.05) and LDH (p < 0.05), lower expression of CRP and higher expression of SOD1 vs SCS. This suggests decreased inflammation and improved ROS scavenging. “Pre-charge” is an effective technique, which allows portability and transport without an O2 source and improves graft parameters. •Oxygen “pre-charge” by 100% O2 for 15 min achieves high, persistent oxygen levels for perfusion.•HMP treatment leads to significant decrease in markers of injury: ALT and sCD-146.•Pre-charged HMP-O2 results in improved aerobic metabolism: decreased LDH.•HMP results in downregulation of CRP expression, a nonspecific marker of inflammation.•HMP results in upregulation of SOD1 expression, an ROS scavenger.
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languageeng
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subjectAbridged Index Medicus ; Allografts ; Analysis ; Animals ; Antibodies ; Biomarkers - metabolism ; Biopsy ; Circuits ; Cold storage ; Cryopreservation ; Death ; Ex vivo perfusion ; Gene expression ; Heart ; Heart transplantation ; Hypothermic machine perfusion ; Hypothermic oxygenated machine perfusion ; Ischemia ; Ischemia/reperfusion injury ; Laboratories ; Liver ; Liver - metabolism ; Liver graft preservation ; Liver Transplantation ; Methods ; Models ; Models, Animal ; Organ Preservation - methods ; Oxygen - administration & dosage ; Oxygenation ; Perfusion ; Perfusion - methods ; Physiological aspects ; Random Allocation ; Scavenging ; Sensors ; Superoxide dismutase ; Swine ; Syngeneic grafts ; Tissue and Organ Procurement - methods ; Transplantation ; Transplants & implants
ispartofThe American journal of surgery, 2020-11, Vol.220 (5), p.1270-1277
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1Rosado, Jesus
2Paterno, Flavio
3Deo, Dayanand
4Dikdan, George
5McCarty, Matthew A
6Arrington, Ben
7Giudice, Anthony
8Fano, Adam
9Dhaduk, Nehal
10Lunsford, Keri E
11Rao, Prakash
12Guarrera, James V
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descriptionHypothermic oxygenated machine perfusion improves outcomes in Liver Transplantation, but application is limited as O2 is supplied by a stationary circuit. A novel technique of O2 “pre-charge” in a portable pump would broaden use and further mitigate ischemia damage from organ transport. Porcine DCD livers were randomized to static cold storage (SCS, n = 8) or hypothermic machine perfusion (HMP). HMP was stratified into HMP-O2 (n = 5), non-O2 open to air HMP-RA (n = 5), and non-O2 with sealed lids or no air HMP-NA (n = 5). HMP-O2 was “pre-charged” using 100% O2 delivered at 10 L/min over 15 min. Perfusate and tissue O2 tension (pO2), liver biopsies, and fluid chemistries were analyzed. “Pre-charge” achieves sustained tissue and perfusate pO2 vs others. HMP-O2 results in decreased markers of hepatocyte injury: ALT (p < 0.05) and LDH (p < 0.05), lower expression of CRP and higher expression of SOD1 vs SCS. This suggests decreased inflammation and improved ROS scavenging. “Pre-charge” is an effective technique, which allows portability and transport without an O2 source and improves graft parameters. •Oxygen “pre-charge” by 100% O2 for 15 min achieves high, persistent oxygen levels for perfusion.•HMP treatment leads to significant decrease in markers of injury: ALT and sCD-146.•Pre-charged HMP-O2 results in improved aerobic metabolism: decreased LDH.•HMP results in downregulation of CRP expression, a nonspecific marker of inflammation.•HMP results in upregulation of SOD1 expression, an ROS scavenger.
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34Scavenging
35Sensors
36Superoxide dismutase
37Swine
38Syngeneic grafts
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titleNovel oxygenation technique for hypothermic machine perfusion of liver grafts: Validation in porcine Donation after Cardiac Death (DCD) liver model
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1Allografts
2Analysis
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4Antibodies
5Biomarkers - metabolism
6Biopsy
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8Cold storage
9Cryopreservation
10Death
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12Gene expression
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abstractHypothermic oxygenated machine perfusion improves outcomes in Liver Transplantation, but application is limited as O2 is supplied by a stationary circuit. A novel technique of O2 “pre-charge” in a portable pump would broaden use and further mitigate ischemia damage from organ transport. Porcine DCD livers were randomized to static cold storage (SCS, n = 8) or hypothermic machine perfusion (HMP). HMP was stratified into HMP-O2 (n = 5), non-O2 open to air HMP-RA (n = 5), and non-O2 with sealed lids or no air HMP-NA (n = 5). HMP-O2 was “pre-charged” using 100% O2 delivered at 10 L/min over 15 min. Perfusate and tissue O2 tension (pO2), liver biopsies, and fluid chemistries were analyzed. “Pre-charge” achieves sustained tissue and perfusate pO2 vs others. HMP-O2 results in decreased markers of hepatocyte injury: ALT (p < 0.05) and LDH (p < 0.05), lower expression of CRP and higher expression of SOD1 vs SCS. This suggests decreased inflammation and improved ROS scavenging. “Pre-charge” is an effective technique, which allows portability and transport without an O2 source and improves graft parameters. •Oxygen “pre-charge” by 100% O2 for 15 min achieves high, persistent oxygen levels for perfusion.•HMP treatment leads to significant decrease in markers of injury: ALT and sCD-146.•Pre-charged HMP-O2 results in improved aerobic metabolism: decreased LDH.•HMP results in downregulation of CRP expression, a nonspecific marker of inflammation.•HMP results in upregulation of SOD1 expression, an ROS scavenger.
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