Impact of human-derived hemoglobin based oxygen vesicles as a machine perfusion solution for liver donation after cardiac death in a pig model

Autoři: Tatsuya Shonaka aff001;  Naoto Matsuno aff001;  Hiromichi Obara aff002;  Ryo Yoshikawa aff002;  Yuji Nishikawa aff003;  Yo Ishihara aff001;  Hiroki Bochimoto aff004;  Mikako Gochi aff001;  Masahide Otani aff001;  Hiroyuki Kanazawa aff001;  Hiroshi Azuma aff005;  Hiromi Sakai aff006;  Hiroyuki Furukawa aff001
Působiště autorů: Department of Surgery, Asahikawa Medical University, Asahikawa-shi, Hokkaido, Japan aff001;  Department of Mechanical Engineering, Tokyo Metropolitan University, Hachioji-shi, Tokyo, Japan aff002;  Department of Pathology, Asahikawa Medical University, Asahikawa-shi, Hokkaido, Japan aff003;  Department of Cell Physiology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan aff004;  Department of Pediatrics, Asahikawa Medical University, Asahikawa-shi, Hokkaido, Japan aff005;  Department of Chemistry, Nara Medical University, Kashihara-shi, Nara, Japan aff006
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article


The recent clinical application of perfusion technology for the machine preservation of donation after cardiac death (DCD) grafts has some advantages. Oxygenation has been proposed for the preservation of DCD liver grafts. The aim of this study is to clarify whether the use of HbV-containing preservation solution during the subnormothermic machine perfusion (SNMP) of the liver graft improves the graft function of DCD porcine livers in an ex vivo reperfusion model. Pig livers were excised after 60 minutes of warm ischemic time and were preserved under one of three preservation conditions for 4 hours. The preservation conditions were as follows: 4°C cold storage (CS group; N = 5), Hypothermic machine preservation (HMP) with UW gluconate solution (HMP group; N = 5), SNMP (21°C) with UW gluconate solution (SNMP group; N = 5), SNMP (21°C) with HbVs (Hb; 1.8 mg/dl) perfusate (SNMP+HbV group; N = 5). Autologous blood perfusion was performed for 2 hours in an isolated liver reperfusion model (IRM). The oxygen consumption of the SNMP and SNMP+HbV group was higher than the HMP groups (p < 0.05). During the reperfusion, the AST level in the SNMP+HbV group was lower than that in the CS, HMP and SNMP groups. The changes in pH after reperfusion was significantly lower in SNMP+HbV group than CS and HMP groups. The ultrastructural findings indicated that the mitochondria of the SNMP+HbV group was well maintained in comparison to the CS, HMP and SNMP groups. The SNMP+HbVs preservation solution protected against metabolic acidosis and preserved the liver function after reperfusion injury in the DCD liver.

Klíčová slova:

Blood – Blood pressure – Hepatocytes – Liver transplantation – Mitochondria – Oxygen – Oxygen consumption – Reperfusion


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