Can apparent diffusion coefficient discriminate ischemic from nonischemic livers? A pilot experimental study

Area of Science:

• Hepatology
• Medical Imaging
• Ischemia Research

Background:

• Apparent diffusion coefficient (ADC) is a magnetic resonance imaging biomarker for cerebral ischemia.
• Hepatic ischemia assessment is crucial for liver transplantation and surgery.
• Ex vivo hypothermic machine perfusion (HMP) is used for liver preservation.

Purpose of the Study:

• To evaluate the utility of ADC in assessing hepatic ischemia during ex vivo HMP and in vivo.
• To compare ADC changes in normal and ischemic porcine livers under different perfusion conditions.

Main Methods:

• Porcine livers underwent ex vivo HMP with acellular or sanguineous preservation solutions, with or without induced warm ischemia (WI).
• In vivo assessment involved occluding liver vessels for WI and subsequent reperfusion.
• Aspartate aminotransferase (AST) levels and histology served as surrogates for WI severity.

Main Results:

• In vivo ADC significantly decreased in the ischemic lobe, indicating successful ischemia detection.
• Ex vivo ADC showed minimal differences between ischemic and non-ischemic livers during acellular perfusion.
• Sanguineous perfusion ex vivo showed a slight, stable difference in ADC between WI and non-WI regions.

Conclusions:

• In vivo ADC reliably reflects hepatic ischemia, mirroring findings in cerebral ischemia.
• ADC's effectiveness in monitoring hepatic ischemia during ex vivo HMP is less conclusive compared to in vivo assessments.