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[PMID]: | 28403128 |
[Au] Autor: | Compagnon P; Levesque E; Hentati H; Disabato M; Calderaro J; Feray C; Corlu A; Cohen JL; Ben Mosbah I; Azoulay D |
[Ad] Endereço: | 1 Service de Chirurgie Digestive, Hépato-Bilio-Pancréatique et Transplantation Hépatique, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Université Paris-Est, Créteil, France. 2 Institut Mondor Recherche Biomédicale (IMRB), Université Paris-Est, Créteil, France. 3 Service de Réanimation Digestive, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Université Paris-Est, Créteil, France. 4 Service d'Anatomopathologie, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Université Paris-Est, Créteil, France. 5 Service d'Hépatologie, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Université Paris-Est, Créteil, France. 6 INSERM, Univ Rennes, INRA, Nutrition Metabolisms and Cancer (NuMeCan), Rennes, France. 7 Biopredic International, Rennes, France. |
[Ti] Título: | An Oxygenated and Transportable Machine Perfusion System Fully Rescues Liver Grafts Exposed to Lethal Ischemic Damage in a Pig Model of DCD Liver Transplantation. |
[So] Source: | Transplantation;101(7):e205-e213, 2017 Jul. | [Is] ISSN: | 1534-6080 |
[Cp] País de publicação: | United States |
[La] Idioma: | eng |
[Ab] Resumo: | BACKGROUND: Control of warm ischemia (WI) lesions that occur with donation after circulatory death (DCD) would significantly increase the donor pool for liver transplantation. We aimed to determine whether a novel, oxygenated and hypothermic machine perfusion device (HMP Airdrive system) improves the quality of livers derived from DCDs using a large animal model. METHODS: Cardiac arrest was induced in female large white pigs by intravenous injection of potassium chloride. After 60 minutes of WI, livers were flushed in situ with histidine-tryptophan-ketoglutarate and subsequently preserved either by simple cold storage (WI-SCS group) or HMP (WI-HMP group) using Belzer-MPS solution. Liver grafts procured from heart-beating donors and preserved by SCS served as controls. After 4 hours of preservation, all livers were transplanted. RESULTS: All recipients in WI-SCS group died within 6 hours after transplantation. In contrast, the HMP device fully protected the liver against lethal ischemia/reperfusion injury, allowing 100% survival rate. A postreperfusion syndrome was observed in all animals of the WI-SCS group but none of the control or WI-HMP groups. After reperfusion, HMP-preserved livers functioned better and showed less hepatocellular and endothelial cell injury, in agreement with better-preserved liver histology relative to WI-SCS group. In addition to improved energy metabolism, this protective effect was associated with an attenuation of inflammatory response, oxidative load, endoplasmic reticulum stress, mitochondrial damage, and apoptosis. CONCLUSIONS: This study demonstrates for the first time the efficacy of the HMP Airdrive system to protect liver grafts from lethal ischemic damage before transplantation in a clinically relevant DCD model. |
[Mh] Termos MeSH primário: |
Hepatectomia Transplante de Fígado/instrumentação Fígado/cirurgia Perfusão/instrumentação Traumatismo por Reperfusão/prevenção & controle Isquemia Quente/instrumentação
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[Mh] Termos MeSH secundário: |
Aloenxertos Animais Biomarcadores/metabolismo Modelos Animais de Doenças Metabolismo Energético Desenho de Equipamento Feminino Glucose/farmacologia Sobrevivência de Enxerto Parada Cardíaca/induzido quimicamente Hepatectomia/efeitos adversos Fígado/metabolismo Fígado/patologia Testes de Função Hepática Transplante de Fígado/efeitos adversos Transplante de Fígado/métodos Manitol/farmacologia Teste de Materiais Soluções para Preservação de Órgãos/farmacologia Perfusão/efeitos adversos Perfusão/métodos Cloreto de Potássio/farmacologia Procaína/farmacologia Traumatismo por Reperfusão/etiologia Traumatismo por Reperfusão/metabolismo Traumatismo por Reperfusão/patologia Sus scrofa Fatores de Tempo Sobrevivência de Tecidos Isquemia Quente/efeitos adversos Isquemia Quente/métodos
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[Pt] Tipo de publicação: | JOURNAL ARTICLE |
[Nm] Nome de substância:
| 0 (Biomarkers); 0 (Bretschneider cardioplegic solution); 0 (Organ Preservation Solutions); 3OWL53L36A (Mannitol); 4Z8Y51M438 (Procaine); 660YQ98I10 (Potassium Chloride); IY9XDZ35W2 (Glucose) |
[Em] Mês de entrada: | 1709 |
[Cu] Atualização por classe: | 170912 |
[Lr] Data última revisão:
| 170912 |
[Sb] Subgrupo de revista: | IM |
[Da] Data de entrada para processamento: | 170414 |
[St] Status: | MEDLINE |
[do] DOI: | 10.1097/TP.0000000000001764 |
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