Attempt to rescue discarded human liver grafts by end ischemic hypothermic oxygenated machine perfusion.
Vekemans K, van Pelt J, et al.Transplantation Proceedings 43(9): 3455-3459, 2011.
Aims
To evaluate the efficacy of end ischemic hypothermic machine perfusion on cold-preserved marginal human liver grafts.
Interventions
Liver grafts were oxygenated by 4 hours of hypothermic machine perfusion versus an additional 4 hours of simple cold storage. All livers were then warm reperfused to mimic ischemia reperfusion injury.
Participants
27 human livers that were considered unsuitable for transplantation but preserved by cold storage.
Outcomes
Biochemical parameters were cumulative release of aspartate amino transferase, lactate dehydrogenase and lactate. Histological parameters included a morphological score that was based on sinusoidal dilatation, enlargement of the space of Disse, congestion, coagulation necrosis, degree of architectural damage and neutrophil infiltration. Endothelin-1 and ICAM-1 were measured by real-time polymerase chain reaction.
Follow-up
2 hours after warm reperfuson.
CET Conclusions
In this small study, hypothermic machine perfusion did lead to improvement in a number of parameters of liver function but with no difference in morphology. This small pilot study suggests the need for further trials of this nature.
Data analysis
Per protocol analysis
Trial registration
Not reported