Core Issues of Mechanical Perfusion in Preservation and Repairing of Donor Liver after Cardiac Death_Journal of Biomedical Engineering

Authors：

XIANGJunxi , ZHENGXinglong , LIUPeng , DONGDinghui , LIUXuemin ,  LUYi

Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi′an Jiaotong University, Xi′an 710061, China;

Corresponding author：

LUYi, Email: luyi169@126.com

Keywords：

mechanical perfusion; donation after cardiac death; liver transplantation; normothermic; bloodfree oxygenation

DOI：

10.7507/1001-5515.20160030

Video：

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The quality of a donor liver after cardiac death is closely associated with energy metabolism during preservation. Ex vivo mechanical perfusion has broad application prospects because this technique can help energy metabolism and repair ischemia injury of donors′ livers. Some core issues are presented in this review in order to provide references for propelling secure application of liver transplantation based on donation after cardiac death.

Citation： XIANGJunxi, ZHENGXinglong, LIUPeng, DONGDinghui, LIUXuemin, LUYi. Core Issues of Mechanical Perfusion in Preservation and Repairing of Donor Liver after Cardiac Death. Journal of Biomedical Engineering, 2016, 33(1): 167-170. doi: 10.7507/1001-5515.20160030 Copy

1.	MORRISSEY P E, MONACO A P. Donation after circulatory death: current practices, ongoing challenges, and potential improvements[J]. Transplantation, 2014, 97(3): 258-264.
2.	AKHTAR M Z, SUTHERLAND A I, HUANG H, et al. The role of hypoxia-inducible factors in organ donation and transplantation: the current perspective and future opportunities[J]. Am J Transplant, 2014, 14(7): 1481-1487.
3.	BRUNS H, SCHEMMER P. Machine perfusion in solid organ transplantation: where is the benefit?[J]. Langenbecks Arch Surg, 2014, 399(4): 421-427.
4.	BELLOMO R, MARINO B, STARKEY G, et al. Extended normothermic extracorporeal perfusion of isolated human liver after warm ischaemia: a preliminary report[J]. Crit Care Resusc, 2014, 16(3): 197-201.
5.	中华医学会器官移植学分会.中国心脏死亡器官捐献工作指南(第2版)[J].中华器官移植杂志,2011,32(12):756-758.
6.	DOYLE M B, COLLINS K, VACHHARAJANI N, et al. Outcomes using grafts from donors after cardiac death[J]. J Am Coll Surg, 2015, 221(1): 142-152.
7.	FIGUEIRA E R, ROCHA-FILHO J A, NAKATANI M, et al. Hepatic ischemic preconditioning increases portal vein flow in experimental liver ischemia reperfusion injury[J]. Hepatobiliary Pancreat Dis Int, 2014, 13(1): 40-47.
8.	NAGAI S, YOSHIDA A, FACCIUTO M, et al. Ischemia time impacts recurrence of hepatocellular carcinoma after liver transplantation[J]. Hepatology, 2015, 61(3): 895-904.
9.	KAGEYAMA S, YAGI S, TANAKA H, et al. Graft reconditioning with nitric oxide gas in rat liver transplantation from cardiac death donors[J]. Transplantation, 2014, 97(6): 618-625.
10.	WEEDER P D, VAN RIJN R, PORTE R J. Machine perfusion in liver transplantation as a tool to prevent non-anastomotic biliary strictures: Rationale, current evidence and future directions[J]. J Hepatol, 2015, 63(1): 265-275.
11.	CLAVIEN P A, HARVEY P R C, STRASBERG S M. Preservation and reperfusion injuries in liver allografts. An overview and synthesis of current studies [J]. Transplantation, 1992, 53(5): 957-978.
12.	BESSEMS M, DOORSCHODT B M, ALBERS P S, et al. Wash-out of the non-heart-beating donor liver: a matter of flush solution and temperature?[J]. Liver Int, 2006, 26(7): 880-888.
13.	HAMMAD A, KAIDO T, UEMOTO S. Perioperative nutritional therapy in liver transplantation[J]. Surg Today, 2015, 45(3): 271-283.
14.	RAVIKUMAR R, LEUVENINK H, FRIEND P J. Normothermic liver preservation: a new paradigm?[J]. Transpl Int, 2015, 28(6): 690-699.
15.	MATSUNO N, UCHIDA K, FURUKAWA H. Impact of machine perfusion preservation of liver grafts from donation after cardiac death[J]. Transplant Proc, 2014, 46(4): 1099-1103.
16.	GUARRERA J V, HENRY S D, SAMSTEIN B, et al. Hypothermic machine preservation in human liver transplantation: the first clinical series[J]. Am J Transplant, 2010, 10(2): 372-381.
17.	BRUINSMA B G, AVRUCH J H, WEEDER P D, et al. Functional human liver preservation and recovery by means of subnormothermic machine perfusion[J]. J Vis Exp, 2015, 27(98): e52777.
18.	BOEHNERT M U, YEUNG J C, BAZERBACHI F, et al. Normothermic acellular ex vivo liver perfusion reduces liver and bile duct injury of pig livers retrieved after cardiac death[J]. Am J Transplant, 2013, 13(6): 1441-1449.
19.	OP DEN DRIES S, KARIMIAN N, SUTTON M E, et al. Ex vivo normothermic machine perfusion and viability testing of discarded human donor livers[J]. Am J Transplant, 2013, 13(5): 1327-1335.
20.	NASSAR A, LIU Qiang, FARIAS K, et al. Ex vivo normothermic machine perfusion is safe, simple, and reliable: results from a large animal model[J]. Surg Innov, 2015, 22(1): 61-69.
21.	VOIGT M R, DELARIO G T. Perspectives on abdominal organ preservation solutions: a comparative literature review[J]. Prog Transplant, 2013, 23(4): 383-391.
22.	MIYAGI S, IWANE T, AKAMATSU Y, et al. The significance of preserving the energy status and microcirculation in liver grafts from non-heart-beating donor[J]. Cell Transplant, 2008, 17(1-2): 173-178.
23.	WU Shengli, WOHLSCHLAEGER J, DE GROOT H, et al. Evaluation of a modified HTK solution containing the new iron chelator LK 614 in an isolated rat liver perfusion model[J]. J Invest Surg, 2009, 22(5): 340-347.
24.	SCHREINEMACHERS M C, BEMELMAN F J, IDU M M, et al. First clinical experience with polysol solution: pilot study in living kidney transplantation[J]. Transplant Proc, 2013, 45(1): 38-45.
25.	KEYHANIAN S, EBRAHIMIFARD M, ZANDI M. Investigation on artificial blood or substitute blood replace the natural blood[J]. Iran J Ped Hematol Oncol, 2014, 4(2): 72-77.
26.	BUMLER H, XIONG Yu, LIU Zhizhao, et al. Novel hemoglobin particles--promising new-generation hemoglobin-based oxygen carriers[J]. Artif Organs, 2014, 38(8): 708-714.

1. MORRISSEY P E, MONACO A P. Donation after circulatory death: current practices, ongoing challenges, and potential improvements[J]. Transplantation, 2014, 97(3): 258-264.
2. AKHTAR M Z, SUTHERLAND A I, HUANG H, et al. The role of hypoxia-inducible factors in organ donation and transplantation: the current perspective and future opportunities[J]. Am J Transplant, 2014, 14(7): 1481-1487.
3. BRUNS H, SCHEMMER P. Machine perfusion in solid organ transplantation: where is the benefit?[J]. Langenbecks Arch Surg, 2014, 399(4): 421-427.
4. BELLOMO R, MARINO B, STARKEY G, et al. Extended normothermic extracorporeal perfusion of isolated human liver after warm ischaemia: a preliminary report[J]. Crit Care Resusc, 2014, 16(3): 197-201.
5. 中华医学会器官移植学分会.中国心脏死亡器官捐献工作指南(第2版)[J].中华器官移植杂志,2011,32(12):756-758.
6. DOYLE M B, COLLINS K, VACHHARAJANI N, et al. Outcomes using grafts from donors after cardiac death[J]. J Am Coll Surg, 2015, 221(1): 142-152.
7. FIGUEIRA E R, ROCHA-FILHO J A, NAKATANI M, et al. Hepatic ischemic preconditioning increases portal vein flow in experimental liver ischemia reperfusion injury[J]. Hepatobiliary Pancreat Dis Int, 2014, 13(1): 40-47.
8. NAGAI S, YOSHIDA A, FACCIUTO M, et al. Ischemia time impacts recurrence of hepatocellular carcinoma after liver transplantation[J]. Hepatology, 2015, 61(3): 895-904.
9. KAGEYAMA S, YAGI S, TANAKA H, et al. Graft reconditioning with nitric oxide gas in rat liver transplantation from cardiac death donors[J]. Transplantation, 2014, 97(6): 618-625.
10. WEEDER P D, VAN RIJN R, PORTE R J. Machine perfusion in liver transplantation as a tool to prevent non-anastomotic biliary strictures: Rationale, current evidence and future directions[J]. J Hepatol, 2015, 63(1): 265-275.
11. CLAVIEN P A, HARVEY P R C, STRASBERG S M. Preservation and reperfusion injuries in liver allografts. An overview and synthesis of current studies [J]. Transplantation, 1992, 53(5): 957-978.
12. BESSEMS M, DOORSCHODT B M, ALBERS P S, et al. Wash-out of the non-heart-beating donor liver: a matter of flush solution and temperature?[J]. Liver Int, 2006, 26(7): 880-888.
13. HAMMAD A, KAIDO T, UEMOTO S. Perioperative nutritional therapy in liver transplantation[J]. Surg Today, 2015, 45(3): 271-283.
14. RAVIKUMAR R, LEUVENINK H, FRIEND P J. Normothermic liver preservation: a new paradigm?[J]. Transpl Int, 2015, 28(6): 690-699.
15. MATSUNO N, UCHIDA K, FURUKAWA H. Impact of machine perfusion preservation of liver grafts from donation after cardiac death[J]. Transplant Proc, 2014, 46(4): 1099-1103.
16. GUARRERA J V, HENRY S D, SAMSTEIN B, et al. Hypothermic machine preservation in human liver transplantation: the first clinical series[J]. Am J Transplant, 2010, 10(2): 372-381.
17. BRUINSMA B G, AVRUCH J H, WEEDER P D, et al. Functional human liver preservation and recovery by means of subnormothermic machine perfusion[J]. J Vis Exp, 2015, 27(98): e52777.
18. BOEHNERT M U, YEUNG J C, BAZERBACHI F, et al. Normothermic acellular ex vivo liver perfusion reduces liver and bile duct injury of pig livers retrieved after cardiac death[J]. Am J Transplant, 2013, 13(6): 1441-1449.
19. OP DEN DRIES S, KARIMIAN N, SUTTON M E, et al. Ex vivo normothermic machine perfusion and viability testing of discarded human donor livers[J]. Am J Transplant, 2013, 13(5): 1327-1335.
20. NASSAR A, LIU Qiang, FARIAS K, et al. Ex vivo normothermic machine perfusion is safe, simple, and reliable: results from a large animal model[J]. Surg Innov, 2015, 22(1): 61-69.
21. VOIGT M R, DELARIO G T. Perspectives on abdominal organ preservation solutions: a comparative literature review[J]. Prog Transplant, 2013, 23(4): 383-391.
22. MIYAGI S, IWANE T, AKAMATSU Y, et al. The significance of preserving the energy status and microcirculation in liver grafts from non-heart-beating donor[J]. Cell Transplant, 2008, 17(1-2): 173-178.
23. WU Shengli, WOHLSCHLAEGER J, DE GROOT H, et al. Evaluation of a modified HTK solution containing the new iron chelator LK 614 in an isolated rat liver perfusion model[J]. J Invest Surg, 2009, 22(5): 340-347.
24. SCHREINEMACHERS M C, BEMELMAN F J, IDU M M, et al. First clinical experience with polysol solution: pilot study in living kidney transplantation[J]. Transplant Proc, 2013, 45(1): 38-45.
25. KEYHANIAN S, EBRAHIMIFARD M, ZANDI M. Investigation on artificial blood or substitute blood replace the natural blood[J]. Iran J Ped Hematol Oncol, 2014, 4(2): 72-77.
26. BUMLER H, XIONG Yu, LIU Zhizhao, et al. Novel hemoglobin particles--promising new-generation hemoglobin-based oxygen carriers[J]. Artif Organs, 2014, 38(8): 708-714.

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