Normothermic extracorporeal human liver perfusion following donation after cardiac death.

Détails

ID Serval
serval:BIB_3A04A14A9D37
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Etude de cas (case report): rapporte une observation et la commente brièvement.
Collection
Publications
Titre
Normothermic extracorporeal human liver perfusion following donation after cardiac death.
Périodique
Critical Care and Resuscitation
Auteur⸱e⸱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
Statut éditorial
Publié
Date de publication
2013
Peer-reviewed
Oui
Volume
15
Numéro
2
Pages
78-82
Langue
anglais
Notes
Publication types: Case Reports ; Journal Article Publication Status: ppublish
Résumé
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.
Mots-clé
Aged, Death, Extracorporeal Circulation/methods, Humans, Liver Failure/surgery, Liver Transplantation/methods, Male, Organ Preservation/methods, Perfusion/methods, Tissue Donors
Pubmed
Web of science
Création de la notice
26/11/2014 21:14
Dernière modification de la notice
20/08/2019 13:29
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