Normothermic extracorporeal human liver perfusion following donation after cardiac death.

Details

Serval ID
serval:BIB_3A04A14A9D37
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Title
Normothermic extracorporeal human liver perfusion following donation after cardiac death.
Journal
Critical Care and Resuscitation
Author(s)
Bellomo R., Marino B., Starkey G., Wang B.Z., Fink M.A., Zhu N., Suzuki S., Houston S., Eastwood G., Calzavacca P., Glassford N., Chambers B., Skene A., Schneider A.G., Jones D., Hilton A., Opdam H., Warrillow S., Gauthier N., Johnson L., Jones R.
ISSN
1441-2772 (Print)
ISSN-L
1441-2772
Publication state
Published
Issued date
2013
Peer-reviewed
Oui
Volume
15
Number
2
Pages
78-82
Language
english
Notes
Publication types: Case Reports ; Journal Article Publication Status: ppublish
Abstract
Liver transplantation is a major life-saving procedure and donation after cardiac death (DCD) has increased the pool of potential liver donors. However, livers procured after DCD are at increased risk of primary graft dysfunction and biliary tract ischaemia. Normothermic extracorporeal liver perfusion (NELP) may increase the ability to protect, evaluate and, in future, transplant DCD livers. We conducted a proof-of-concept experiment using a human liver procured by DCD (deemed not suitable for liver donation) to assess the short-term (3 hours) feasibility, histological effects and functional efficacy of NELP. We used an extracorporeal membrane oxygenation circuit with separate hepatic artery and portal vein perfusion to achieve physiological perfusion pressures, and coupled this with parenteral nutrition and an insulin infusion. We achieved NELP with evidence of liver function (bile production, paracetamol removal and control of ammonia, bilirubin and lactate levels) for 3 hours. There was essentially normal liver and biliary tract histology after 8 hours of perfusion. Our experiment justifies further investigation of the feasibility and efficacy of human DCD liver preservation by NELP.
Keywords
Aged, Death, Extracorporeal Circulation/methods, Humans, Liver Failure/surgery, Liver Transplantation/methods, Male, Organ Preservation/methods, Perfusion/methods, Tissue Donors
Pubmed
Web of science
Create date
26/11/2014 21:14
Last modification date
20/08/2019 13:29
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