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Ex vivo perfusion for accurate assessment of liver graft viability in dogs
K Fukuzawa1, M Shimada, K Takenaka
1Second Department of Surgery, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Abstract:
A new type of ex vivo liver perfusion model (EVPM) was developed. The system includes a physiological porto-portal connection, using a centrifugal pump and an aorto-aortal connection, through a heparin-coated tube. Ten pairs of mongrel dogs, weighing 13-20 kg, were used. Grafts of the liver procured from donors were perfused on the EVPM for 3 h. These grafts were divided into two groups: group A (n = 5), nonpreserved graft; group B (n = 5), 8-h graft preserved with lactated Ringer's solution (4 degrees C). The orthotopic liver transplantation (OLTx) series with the nonpreserved graft was reviewed, and dogs surviving for over 7 days following OLTx, group C (n = 5), were selected for liver grafts in the actual OLTx. In comparison with groups A and C, no difference was noted among enzyme levels (sGOT, sGPT, LDH) or in the recovery rate of ATP content in the graft liver tissue after revascularization. There were significant differences between group A and group B after revascularization. This simple and physiological EVPM accurately reflects graft function and hemodynamics in the actual OLTx. Graft viability, as a substitute for OLTx, in large animals can be reliably assessed. This EVPM is expected to contribute to research on events related to liver transplantation.