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Preservation Of Porcine Donation After Circulatory Death (dcd) Liver By Perfusion And Orthotopic Liver Transplantation.

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Preservation Of Porcine Donation After Circulatory Death (dcd) Liver By Perfusion And Orthotopic Liver Transplantation.

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Preservation of Porcine Donation after Circulatory Death (DCD) Liver by Perfusion and Orthotopic Liver

Qing OuYang¹, Xiaoyu Tan¹, Liyue Sun²

¹Department of Hepatobiliary Surgery and Liver Transplant Center, PLA General Hospital of Southern Theatre Command: People's Liberation Army General Hospital of Southern Theatre Command.

Journal of Visualized Experiments : Jove

|July 1, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Static cold storage worsens liver injury in donation after circulatory death (DCD) livers. Machine perfusion (MP) offers a solution, with new methods improving DCD liver preservation and enhancing pig liver transplants.

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Area of Science:

Transplantation Biology
Surgical Innovation
Organ Preservation

Background:

Static cold storage (SCS) causes significant ischemic injury in livers from donors after circulatory death (DCD), complicating liver transplantation.
Machine perfusion (MP) technology is emerging as a clinical solution for donor liver preservation.
Large animal models are crucial for validating MP technologies before human application, but challenges remain in porcine DCD liver preservation and transplantation.

Purpose of the Study:

To evaluate the efficacy of a variable temperature-controlled MP device for prolonged preservation of DCD livers.
To optimize the porcine orthotopic liver transplantation (OLTx) model for DCD livers.
To address challenges in DCD liver preservation, viability assessment, ischemic injury mitigation, and anhepatic phase reduction.

Main Methods:

Utilized a variable temperature-controlled MP device employing sequential Dual Hypothermic Oxygenated Perfusion (DHOPE) and Normothermic Machine Perfusion (NMP) modes.
Developed and refined techniques for ex vivo preservation of DCD porcine livers.
Optimized surgical procedures, including anastomosis, within a porcine OLTx model.

Main Results:

The MP protocol enabled prolonged preservation of DCD livers.
The sequential DHOPE and NMP perfusion strategy improved DCD liver quality.
The enhanced porcine OLTx model demonstrated optimized anastomosis and a reduced anhepatic phase duration.

Conclusions:

Variable temperature-controlled MP, using sequential DHOPE and NMP, effectively preserves DCD livers.
This approach significantly enhances the porcine OLTx model, improving DCD liver quality and surgical outcomes.
MP technology shows promise for overcoming limitations in DCD liver preservation and transplantation.