Development of an extracorporeal liver support system: initial results

Area of Science:

• Surgical Innovation
• Organ Perfusion Technology
• Preclinical Research

Background:

• Developing effective methods for preserving organs outside the body is crucial for transplantation and research.
• Extracorporeal perfusion techniques aim to maintain organ viability ex vivo.
• Normothermic perfusion mimics physiological conditions, potentially improving organ outcomes.

Purpose of the Study:

• To assess the feasibility of performing extracorporeal normothermic perfusion on porcine livers.
• To identify key factors contributing to successful ex vivo liver perfusion in a preclinical model.

Main Methods:

• Seven donor hepatectomies were performed on small pigs (10 kg).
• Livers were placed in a custom-designed perfusion cassette.
• Utilized a roller pump for hepatic artery inflow and a centrifugal pump for vena cava outflow, with partial portal vein recirculation.

Main Results:

• Four out of seven perfusions were technical failures.
• Three perfusions were successful, lasting 50, 65, and 90 minutes.
• Common factors in successful perfusions included specific pump configurations, rapid visual improvement ('pinking up') of the liver, and bile production.

Conclusions:

• Extracorporeal normothermic perfusion of the porcine liver is feasible.
• Specific technical elements, including inflow/outflow pump strategies and observed physiological responses, are critical for success.
• This pilot study provides a foundation for further investigation into ex vivo liver perfusion techniques.