Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Leber, B; Schlechter, S; Weber, J; Rohrhofer, L; Niedrist, T; Aigelsreiter, A; Stiegler, P; Schemmer, P.
Experimental long-term sub-normothermic machine perfusion for non-allocable human liver grafts: first data towards feasibility
EUR SURG. 2022;
Doi: 10.1007/s10353-022-00756-w
Web of Science
FullText
FullText_MUG
- Führende Autor*innen der Med Uni Graz
- Leber Bettina
- Stiegler Philipp
- Co-Autor*innen der Med Uni Graz
- Aigelsreiter Ariane
- Niedrist Tobias
- Rohrhofer Lisa
- Schemmer Peter
- Schlechter Stephanie
- Weber Jennifer
- Altmetrics:
- Dimensions Citations:
- Plum Analytics:
- Scite (citation analytics):
- Abstract:
- Background Patients with end-stage liver disease can only be cured by liver transplantation. Due to the gap between demand and supply, surgeons are forced to use expanded criteria donor (ECD) organs, which are more susceptible to ischemia-reperfusion injury (IRI). Therefore, enhanced storing techniques are required. Machine perfusion (MP) has moved into the spotlight of research because of its feasibility for investigating liver function prior to implantation. However, as the perfect MP protocol has not yet been found, we aimed to investigate the potential of sub-normothermic (SN)MP in this field. Methods Non-allocable human livers were subjected to 24 h of SNMP at 21 degrees C after delivery to the study team. Perfusion was performed with Custodiol (R) (Dr. Franz Kohler Chemie, Bensheim, Germany) or Belzer MPS (R) (Bridge to Life Europe, London, UK) and perfusate liver parameters were determined. For determination of biliary conditions, pH, glucose, and HCO3- levels were measured. Results Liver parameters were slightly increased irrespective of perfusate or reason for liver rejection during 24 h of perfusion. Six livers failed to produce bile completely, whereas the remaining 10 livers produced between 2.4 ml and 179 ml of bile. Biliary carbonate was increased in all but one liver. The bile-glucose-to-perfusate-glucose ratio was near 1 for most of the organs and bile pH was above 7 in all but one case. Conclusion This study provides promising data on the feasibility of long-term SNMP as a tool to gain time during MP to optimize ECD organs to decrease the gap between organ demand and supply. Long-term (24 h) sub-normothermic liver machine perfusion seems to be possible, although some adjustments to the protocol might be necessary to improve the general outcome. This has so far been shown for normothermic machine perfusion, bearing some drawbacks compared to the sub-normothermic variant.
- Find related publications in this database (Keywords)
- Sub-normothermic
- Liver
- Organ shortage
- Organ reconditioning
- Extended criteria donor