Abstract
Background
Deceased cardiac donors (DCDs) have become a useful source of organs for liver transplantation;
nevertheless, there are concerns about the longevity of these grafts. The aim of this
study was to evaluate the use of extracorporeal membrane oxygenation (ECMO) to resuscitate
DCD porcine livers as a preclinical model using hepatocyte isolation and viability
as a marker to assess whole-graft preservation.
Materials and methods
We randomized Landrace pigs into three groups after cardiac death and 30 min of warm
ischemia: group 1, peritoneal cooling with intravascular cooling for 2 h; group 2,
ECMO for 2 h; and group 3, control (conventional intravascular cooling and retrieval).
We then reperfused group 1 and 2 livers for 2 h on an ex vivo reperfusion circuit and isolated hepatocytes.
Results
After reperfusion, hepatocyte viability was significantly improved in the ECMO group
compared to the cooling groups, as measured by trypan blue, methylthiazolyldiphenyl-tetrazolium
bromide, and seeding efficiency. Glycogen and reduced glutathione content were significantly
used in the ECMO group both before and after reperfusion compared with group 2. The
adenosine diphosphate:adenosine triphosphate ratio showed an improved trend (lower)
in the ECMO group compared with the cooling group but did not reach statistical significance
either before or after reperfusion.
Conclusions
This preclinical study suggests that ECMO is a viable technique for liver preservation
that gives an improved yield of hepatocytes when isolated from a DCD liver, suggesting
improved liver preservation.
Keywords
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Article info
Publication history
Published online: April 01, 2013
Accepted:
March 7,
2013
Received in revised form:
March 3,
2013
Received:
November 19,
2012
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
