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normothermic machine perfusion

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https://www.readbyqxmd.com/read/29674604/does-ischemia-free-liver-procurement-under-normothermic-perfusion-benefit-the-outcome-of-liver-transplantation
#1
Qiang Zhao, Shanzhou Huang, Dongping Wang, Zhiheng Zhang, Linwei Wu, Lu Yang, Yi Ma, Fei Ji, Yunhua Tang, Linhe Wang, Zebin Zhu, Yanling Zhu, Wei Xiong, Maogen Chen, Ming Han, Jian Zhou, Anbin Hu, Guodong Wang, Xingyuan Jiao, Xiaofeng Zhu, Weiqiang Ju, Zhiyong Guo, Xiaoshun He
BACKGROUND In contrast to conventional static cold preservation, normothermic machine perfusion (NMP) provides a beneficial alternative preservation of donor livers. However, the liver still suffered cold ischemic injury before attaching to the perfusion device. MATERIAL AND METHODS To prevent cold ischemic injury during procurement, we describe a novel procedure called ischemia-free liver procurement (IFLP) under NMP. Two liver grafts were procured from brain death donor under NMP and underwent 2-hour ex vivo NMP followed by 3 and 6 hours of static cold preservation...
April 20, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29670285/a-randomized-trial-of-normothermic-preservation-in-liver-transplantation
#2
David Nasralla, Constantin C Coussios, Hynek Mergental, M Zeeshan Akhtar, Andrew J Butler, Carlo D L Ceresa, Virginia Chiocchia, Susan J Dutton, Juan Carlos García-Valdecasas, Nigel Heaton, Charles Imber, Wayel Jassem, Ina Jochmans, John Karani, Simon R Knight, Peri Kocabayoglu, Massimo Malagò, Darius Mirza, Peter J Morris, Arvind Pallan, Andreas Paul, Mihai Pavel, M Thamara P R Perera, Jacques Pirenne, Reena Ravikumar, Leslie Russell, Sara Upponi, Chris J E Watson, Annemarie Weissenbacher, Rutger J Ploeg, Peter J Friend
Liver transplantation is a highly successful treatment, but is severely limited by the shortage in donor organs. However, many potential donor organs cannot be used; this is because sub-optimal livers do not tolerate conventional cold storage and there is no reliable way to assess organ viability preoperatively. Normothermic machine perfusion maintains the liver in a physiological state, avoids cooling and allows recovery and functional testing. Here we show that, in a randomized trial with 220 liver transplantations, compared to conventional static cold storage, normothermic preservation is associated with a 50% lower level of graft injury, measured by hepatocellular enzyme release, despite a 50% lower rate of organ discard and a 54% longer mean preservation time...
April 18, 2018: Nature
https://www.readbyqxmd.com/read/29644030/proof-of-concept-liver-splitting-during-normothermic-machine-perfusion
#3
Barney T F Stephenson, Glenn K Bonney, Richard W Laing, Ricky H Bhogal, Francesca Marcon, Desley A H Neil, M Thamara P R Perera, Simon C Afford, Hynek Mergental, Darius F Mirza
Introduction: Despite utilizing extended criteria donors, there remains a shortage of livers for transplantation. No data exists on splitting donor livers with concurrent NMP-L. Methods: A liver recovered from a donor after circulatory death was subjected to NMP-L using a red cell based fluid. During NMP-L, a 'classical' left lateral + right trisegmentectomy split was performed using an integrated bipolar/ultrasonic device. After splitting, blood flow was confirmed using Doppler ultrasound in each lobe...
March 2018: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29629996/normothermic-liver-preservation-current-status-and-future-directions
#4
Danielle Detelich, James F Markmann
PURPOSE OF REVIEW: Normothermic machine perfusion (NMP) is an emerging technology for liver preservation. Early clinical results demonstrate beneficial effects in reconditioning high-risk grafts. This review discusses the role of normothermic perfusion as a tool to assess graft viability and as a platform for graft intervention and modification. RECENT FINDINGS: The potential benefits of NMP extend far beyond organ reconditioning. Recent pilot studies have identified clinically relevant viability criteria, which now require validation in large randomized control trials prior to implementation...
April 7, 2018: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29609847/angiotensin-iv-improves-subnormothermic-machine-perfusion-preservation-of-rat-liver-graft
#5
Donia Tabka, Mohamed Bejaoui, James Javellaud, Jean-Michel Achard, Hassen Ben Abdennebi
This study aims to determine whether Angiotensin IV (Ang IV) addition to Celsior preservation solution could improve hepatic endothelium function and provide better liver protection during subnormothermic machine preservation (SMP). Two experimental models were used: In the first part of the study, rings isolated from rat hepatic artery were preserved in Celsior solution (6 h, 20 °C) with and without Ang IV (10-9  M), then, endothelium-dependent relaxation (EDR) and the concentration of acetylcholine inducing half-maximal relaxation of pre-contracted rings (EC50) were measured...
March 30, 2018: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/29567935/normothermic-machine-perfusion-versus-cold-storage-of-liver-in-pig-model-a-meta-analysis
#6
Shiqi Bian, Zhijun Zhu, Liying Sun, Lin Wei, Wei Qu, Zhigui Zeng, Ying Liu
BACKGROUND Normothermic machine perfusion (NMP) is a novel strategy used for organ preservation. We aimed to determine the overall efficacy of NMP for liver preservation versus traditional static cold storage (CS). MATERIAL AND METHODS We performed a meta-analysis of the literature to evaluate the efficacy of NMP in experimental pig models of liver preservation. We use the standardized mean difference and 95% confidence intervals (CI) to calculate statistics and used the random effects model for the combined analysis of the results...
March 23, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29564207/normothermic-machine-preservation-of-the-liver-state-of-the-art
#7
REVIEW
Carlo D L Ceresa, David Nasralla, Wayel Jassem
Purpose of Review: This review aims to introduce the concept of normothermic machine perfusion (NMP) and its role in liver transplantation. By discussing results from recent clinical studies and highlighting the potential opportunities provided by this technology, we aim to provide a greater insight into NMP and the role it can play to enhance liver transplantation. Recent Findings: NMP has recently been shown to be both safe and feasible in liver transplantation and has also demonstrated its superiority to traditional cold storage in terms of early biochemical liver function...
2018: Current Transplantation Reports
https://www.readbyqxmd.com/read/29564205/from-gut-feeling-to-objectivity-machine-preservation-of-the-liver-as-a-tool-to-assess-organ-viability
#8
REVIEW
Christopher J E Watson, Ina Jochmans
Purpose of Review: The purpose of this review was to summarise how machine perfusion could contribute to viability assessment of donor livers. Recent Findings: In both hypothermic and normothermic machine perfusion, perfusate transaminase measurement has allowed pretransplant assessment of hepatocellular damage. Hypothermic perfusion permits transplantation of marginal grafts but as yet has not permitted formal viability assessment. Livers undergoing normothermic perfusion have been investigated using parameters similar to those used to evaluate the liver in vivo...
2018: Current Transplantation Reports
https://www.readbyqxmd.com/read/29424767/extracellular-vesicles-from-human-liver-stem-cells-reduce-injury-in-an-ex-vivo-normothermic-hypoxic-rat-liver-perfusion-model
#9
Federica Rigo, Nicola De Stefano, Victor Navarro-Tableros, Ezio David, Giorgia Rizza, Giorgia Catalano, Nicholas Gilbo, Francesca Maione, Federica Gonella, Dorotea Roggio, Silvia Martini, Damiano Patrono, Mauro Salizzoni, Giovanni Camussi, Renato Romagnoli
BACKGROUND: The gold standard for organ preservation before transplantation is static cold storage, which is unable to fully protect suboptimal livers from ischemia/reperfusion injury. An emerging alternative is normothermic machine perfusion (NMP), which permits organ reconditioning. Here, we aimed to explore the feasibility of a pharmacological intervention on isolated rat livers by using a combination of NMP and human liver stem cells-derived extracellular vesicles (HLSC-EV). METHODS: We established an ex vivo murine model of NMP capable to maintain liver function despite an ongoing hypoxic injury induced by hemodilution...
February 9, 2018: Transplantation
https://www.readbyqxmd.com/read/29406445/protecting-donor-livers-during-normothermic-machine-perfusion-with-stem-cell-evs
#10
Ashish K Sharma, Victor E Laubach
No abstract text is available yet for this article.
February 5, 2018: Transplantation
https://www.readbyqxmd.com/read/29358854/mechanisms-of-autophagy-activation-in-endothelial-cell-and-their-targeting-during-normothermic-machine-liver-perfusion
#11
REVIEW
Yuri L Boteon, Richard Laing, Hynek Mergental, Gary M Reynolds, Darius F Mirza, Simon C Afford, Ricky H Bhogal
Ischaemia-reperfusion injury (IRI) is the leading cause of injury seen in the liver following transplantation. IRI also causes injury following liver surgery and haemodynamic shock. The first cells within the liver to be injured by IRI are the liver sinusoidal endothelial cells (LSEC). Recent evidence suggests that LSEC co-ordinate and regulates the livers response to a variety of injuries. It is becoming increasingly apparent that the cyto-protective cellular process of autophagy is a key regulator of IRI...
December 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29329185/vasodilation-during-normothermic-machine-perfusion-preventing-the-no-reflow-phenomena
#12
Ahmed Nassar, Cristiano Quintini
No abstract text is available yet for this article.
April 2018: Transplantation
https://www.readbyqxmd.com/read/29325720/development-of-pancreatic-machine-perfusion-translational-steps-from-porcine-to-human-models
#13
Karim Hamaoui, Sally Gowers, Bynvant Sandhu, Natalie Vallant, Terry Cook, Martyn Boutelle, Daniel Casanova, Vassilios Papalois
BACKGROUND: Hypothermic machine perfusion (HMP) is increasingly being used for extended criteria kidney grafts. Pancreatic HMP is challenging because physiologically the pancreas is a low-flow organ susceptible to edema. We report the successful development of preclinical HMP models using porcine pancreases, as well as human pancreases unsuitable for clinical transplantation. METHODS: Ten porcine pancreases were used in the development of these perfusion models...
March 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29316214/retracted-normothermic-machine-perfusion-protects-against-liver-ischemic-reperfusion-injury-during-reduced-size-liver-transplantation-in-pigs
#14
Zhi-Bin Zhang, Lei Liu, Wei Gao, Yuan Shi, Ning Ma, Zhong-Yang Shen
No abstract text is available yet for this article.
January 5, 2018: Liver Transplantation
https://www.readbyqxmd.com/read/29281862/normothermic-machine-perfusion-of-donor-livers-without-the-need-for-human-blood-products
#15
Alix P M Matton, Laura C Burlage, Rianne van Rijn, Yvonne de Vries, Shanice A Karangwa, Maarten W Nijsten, Annette S H Gouw, Janneke Wiersema-Buist, Jelle Adelmeijer, Andrie C Westerkamp, Ton Lisman, Robert J Porte
Normothermic machine perfusion (NMP) enables viability assessment of donor livers prior to transplantation. NMP is frequently performed by using human blood products including red blood cells (RBCs) and fresh frozen plasma (FFP). Our aim was to examine the efficacy of a novel machine perfusion solution based on polymerized bovine hemoglobin-based oxygen carrier (HBOC)-201. Twenty-four livers declined for transplantation were transported by using static cold storage. Upon arrival, livers underwent NMP for 6 hours using pressure-controlled portal and arterial perfusion...
April 2018: Liver Transplantation
https://www.readbyqxmd.com/read/29239091/extra-corporeal-normothermic-machine-perfusion-of-the-porcine-kidney-working-towards-future-utilization-in-australasia
#16
Ahmer M Hameed, Ray Miraziz, David B Lu, Neil Warwick, Ali El-Ayoubi, Heather Burns, Yi Vee Chew, Ross Matthews, Greg O'Grady, Lawrence Yuen, Natasha Rogers, Henry C Pleass, Wayne J Hawthorne
BACKGROUND: The ongoing supply-demand gap with respect to donor kidneys for transplantation necessitates the increased use of higher kidney donor profile index and/or donation after circulatory death (DCD) kidneys. Machine perfusion (MP) preservation has become increasingly popular as a means to preserve such organs. Human data regarding normothermic kidney MP (NMP) is in its infancy, and such a system has not been established in the Australasian clinical setting. METHODS: Modified cardio-pulmonary bypass technology was utilized to develop a viable NMP kidney perfusion system using a porcine DCD model...
December 14, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29210064/normothermic-machine-perfusion-for-the-assessment-and-transplantation-of-declined-human-kidneys-from-donation-after-circulatory-death-donors
#17
S A Hosgood, E Thompson, T Moore, C H Wilson, M L Nicholson
BACKGROUND: A significant proportion of donation after circulatory death (DCD) kidneys are declined for transplantation because of concerns over their quality. Ex vivo normothermic machine perfusion (NMP) provides a unique opportunity to assess the quality of a kidney and determine its suitability for transplantation. METHODS: In phase 1 of this study, declined human DCD kidneys underwent NMP assessment for 60 min. Kidneys were graded 1-5 using a quality assessment score (QAS) based on macroscopic perfusion, renal blood flow and urine output during NMP...
March 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29189484/comparison-of-bq123-epoprostenol-and-verapamil-as-vasodilators-during-normothermic-ex-vivo-liver-machine-perfusion
#18
Juan Echeverri, Nicolas Goldaracena, Johan Moritz Kaths, Ivan Linares, Roizar Roizales, Dagmar Kollmann, Matyas Hamar, Peter Urbanellis, Sujani Ganesh, Oyedele A Adeyi, Mahmood Tazari, Markus Selzner, Nazia Selzner
BACKGROUND: The optimal vasodilator to avoid hepatic artery (HA) vasospasm during normothermic ex vivo liver perfusion (NEVLP) is yet to be determined. We compared safety and efficacy of BQ123 (endothelin1 antagonist), Epoprostenol (prostacyclin analogue), and Verapamil (calcium channel antagonist). METHODS: Livers from porcine heart beating donors were perfused for 3 hours and transplanted into recipient pigs. Four groups were compared: Group 1: livers perfused with a dose of 1...
November 20, 2017: Transplantation
https://www.readbyqxmd.com/read/29187644/nanoparticle-targeting-to-the-endothelium-during-normothermic-machine-perfusion-of-human-kidneys
#19
Gregory T Tietjen, Sarah A Hosgood, Jenna DiRito, Jiajia Cui, Deeksha Deep, Eric Song, Jan R Kraehling, Alexandra S Piotrowski-Daspit, Nancy C Kirkiles-Smith, Rafia Al-Lamki, Sathia Thiru, J Andrew Bradley, Kourosh Saeb-Parsy, John R Bradley, Michael L Nicholson, W Mark Saltzman, Jordan S Pober
Ex vivo normothermic machine perfusion (NMP) is a new clinical strategy to assess and resuscitate organs likely to be declined for transplantation, thereby increasing the number of viable organs available. Short periods of NMP provide a window of opportunity to deliver therapeutics directly to the organ and, in particular, to the vascular endothelial cells (ECs) that constitute the first point of contact with the recipient's immune system. ECs are the primary targets of both ischemia-reperfusion injury and damage from preformed antidonor antibodies, and reduction of perioperative EC injury could have long-term benefits by reducing the intensity of the host's alloimmune response...
November 29, 2017: Science Translational Medicine
https://www.readbyqxmd.com/read/29183928/viability-testing-and-transplantation-of-marginal-livers-vittal-using-normothermic-machine-perfusion-study-protocol-for-an-open-label-non-randomised-prospective-single-arm-trial
#20
Richard W Laing, Hynek Mergental, Christina Yap, Amanda Kirkham, Manpreet Whilku, Darren Barton, Stuart Curbishley, Yuri L Boteon, Desley A Neil, Stefan G Hübscher, M Thamara P R Perera, Paolo Muiesan, John Isaac, Keith J Roberts, Hentie Cilliers, Simon C Afford, Darius F Mirza
INTRODUCTION: The use of marginal or extended criteria donor livers is increasing. These organs carry a greater risk of initial dysfunction and early failure, as well as inferior long-term outcomes. As such, many are rejected due to a perceived risk of use and use varies widely between centres. Ex situ normothermic machine perfusion of the liver (NMP-L) may enable the safe transplantation of organs that meet defined objective criteria denoting their high-risk status and are currently being declined for use by all the UK transplant centres...
November 28, 2017: BMJ Open
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