The impact of short-term machine perfusion on the risk of cancer recurrence after rat liver transplantation with donors after circulatory death


Autoři: Graziano Oldani aff001;  Andrea Peloso aff001;  Florence Slits aff003;  Quentin Gex aff003;  Vaihere Delaune aff001;  Lorenzo A. Orci aff001;  Yohan van de Looij aff004;  Didier J. Colin aff006;  Stéphane Germain aff006;  Claudio de Vito aff002;  Laura Rubbia-Brandt aff002;  Stéphanie Lacotte aff003;  Christian Toso aff001
Působiště autorů: Division of Abdominal Surgery, Department of Surgery, Faculty of Medicine, University of Geneva, Geneva, Switzerland aff001;  Hepato-Pancreato-Biliary Centre, Geneva University Hospitals, Geneva, Switzerland aff002;  Division of Abdominal Surgery, Department of Surgery, Faculty of Medicine, University of Geneva, Geneva, Switzerland aff003;  Division of Child Development & Growth, University Children's Hospital Geneva, Geneva, Switzerland aff004;  Institute of Translational Molecular Imaging, University of Geneva, Geneva, Switzerland aff005;  MicroPET/SPECT/CT Imaging Laboratory, Centre for BioMedical Imaging, Geneva University Hospitals and University of Geneva, Geneva, Switzerland aff006;  Division of Clinical Pathology, Department of Pathology and Immunology, Geneva University Hospitals and University of Geneva, Geneva, Switzerland aff007
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: 10.1371/journal.pone.0224890

Souhrn

Hypothermic and normothermic ex vivo liver perfusions promote organ recovery after donation after circulatory death (DCD). We tested whether these perfusions can reduce the risk of hepatocellular carcinoma (HCC) recurrence in a 1h-DCD syngeneic transplantation model, using Fischer F344 rats. DCD grafts were machine perfused for 2h with hypothermic perfusion (HOPE) or normothermic perfusion (NORMO), and transplanted. After reperfusion, we injected HCC cells into the vena porta. On day 28 after transplantation, we assessed tumour volumes by MRI. Control rats included transplantations with Fresh and non-perfused DCD livers. We observed apoptotic-necrotic hepatocyte foci in all DCD grafts, which were more visible than in the Fresh liver grafts. Normothermic perfusion allowed a faster post-transplant recovery, with lower day 1 levels of transaminases compared with the other DCD. Overall, survival was similar in all four groups and all animals developed HCCs. Total tumor volume was lower in the Fresh liver recipients compared to the DCD and DCD+HOPE recipients. Volumes in DCD+NORMO recipients were not significantly different from those in the Fresh group. This experiment confirms that ischemia/reperfusion injury promotes HCC cell engraftment/growth after DCD liver transplantation. Using the present extreme 1h ischemia model, both hypothermic and normothermic perfusions were not effective in reducing this risk.

Klíčová slova:

Bile – Hepatocellular carcinoma – Liver – Liver transplantation – Magnetic resonance imaging – Medical implants – Oxygen – Reperfusion


Zdroje

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