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Normothermic Ex vivo liver perfusion

Mihai-Calin Pavel, Constantino Fondevila Campo, Victor Molina Santos, Alba Diaz Lorca, Juan Carlos Garcia-Valdecasas Salgado
No abstract text is available yet for this article.
October 19, 2016: Cirugía Española
Mariusz Bral, Boris Gala-Lopez, David Bigam, Norman Kneteman, Andrew Malcolm, Scott Livingstone, Axel Andres, Juliet Emamaullee, Leslie Russell, Constantin Coussios, Lori J West, Peter J Friend, A M James Shapiro
After extensive experimentation, outcomes of a first clinical normothermic machine perfusion (NMP) liver UK trial demonstrated feasibility and clear safety, with improved liver function when compared to standard static cold storage (SCS). We herein present a preliminary single centre North-American experience using identical NMP technology. Ten donor liver grafts were procured, 4 (40%) from donation after circulatory death (DCD) donors, of which 9 were transplanted. One liver did not proceed due to a technical failure with portal cannulation, and discarded...
September 17, 2016: American Journal of Transplantation
Nicolas Goldaracena, Juan Echeverri, Vinzent N Spetzler, Johan M Kaths, Andrew S Barbas, Kristine S Louis, Oyedele A Adeyi, David R Grant, Nazia Selzner, Markus Selzner
INTRODUCTION: Normothermic ex vivo liver perfusion (NEVLP) improves graft preservation by avoiding cold ischemic injury. We investigated whether the protective effects of NEVLP can be further improved by applying strategies targeted on reducing the activation of pro-inflammatory cytokines during perfusion. METHODS: Livers retrieved under heart beating conditions were perfused for 4 hours. Following preservation period, pig liver transplantation was performed. In group-1 (n=5) anti-inflammatory strategies (alprostadil, n-acetylcysteine, CO and sevoflurane, subnormothermic temperature (33°C)) were applied...
August 24, 2016: Liver Transplantation
A S Barbas, S J Knechtle
In this issue of the American Journal of Transplantation, Mergental and colleagues from Birmingham, UK report the successful transplantation of five discarded liver allografts following an evaluation period by normothermic ex-vivo liver perfusion (NEVLP) (1). They applied a combination of objective (perfusate lactate/pH, bile production This article is protected by copyright. All rights reserved.
July 12, 2016: American Journal of Transplantation
Markus Selzner, Nicolas Goldaracena, Juan Echeverri, Johan M Kaths, Ivan Linares, Nazia Selzner, Cyril Serrick, Max Marquez, Gonzalo Sapisochin, Eberhard L Renner, Mamatha Bhat, Ian D McGilvray, Leslie Lilly, Paul D Greig, Cynthia Tsien, Mark S Cattral, Anand Ghanekar, David R Grant
: The European trial investigating normothermic ex vivo liver perfusion (NEVLP) as a preservation technique for liver transplantation (LT) uses Gelofusine(TM) , a non-FDA approved bovine derived gelatin-based perfusion solution. We report a safety and feasibility clinical NEVLP trial with human albumin based Steen solution. METHODS: Transplant outcomes of 10 human liver grafts that were perfused on the Metra(TM) device at 37°C with Steen solution, plus 3 units of erythrocytes were compared to a matched historical control group of 30 grafts using cold storage (CS) as the preservation technique...
June 24, 2016: Liver Transplantation
Christopher J E Watson, Lucy V Randle, Vasilis Kosmoliaptsis, Paul Gibbs, Michael Allison, Andrew J Butler
No abstract text is available yet for this article.
June 10, 2016: Annals of Surgery
A S Barbas, N Goldaracena, M J Dib, M Selzner
Liver transplantation is the optimal treatment for end-stage liver disease but is limited by the severe shortage of donor organs. This shortage has prompted increased utilization of marginal grafts from DCD and extended criteria donors, which poorly tolerate cold storage in comparison to standard criteria grafts. Ex-vivo liver perfusion (EVLP) technology has emerged as a potential alternative to cold storage for organ preservation, but there is no consensus regarding the optimal temperature or conditions for EVLP...
July 2016: Transplantation Reviews
Nicolas Goldaracena, Andrew S Barbas, Markus Selzner
PURPOSE OF REVIEW: In the current era of extreme organ shortage, warm (subnormothermic and normothermic) ex-vivo liver perfusion has emerged as a novel strategy to recover marginal organs and increase the organ pool. Over the last decade, significant progress in the field has taken this technology from bench to bedside. This review will cover the most relevant contributions to the field in 2015. RECENT FINDINGS: Several groups made significant advances in warm ex-vivo liver perfusion for optimizing preservation of liver grafts...
June 2016: Current Opinion in Organ Transplantation
Ahmed Nassar, Qiang Liu, Kevin Farias, Laura Buccini, William Baldwin, Ana Bennett, Martin Mangino, Samuel Irefin, Jacek Cywinski, Toshihiro Okamoto, Teresa Diago Uso, Giuseppe Iuppa, Basem Soliman, Charles Miller, Cristiano Quintini
Normothermic machine perfusion (NMP) has been introduced as a promising technology to preserve and possibly repair marginal liver grafts. The aim of this study was to compare the effect of temperature on the preservation of donation after cardiac death (DCD) liver grafts in an ex vivo perfusion model after NMP (38.5°C) and subnormothermic machine perfusion (SNMP, 21°C) with a control group preserved by cold storage (CS, 4°C). Fifteen porcine livers with 60 min of warm ischemia were preserved for 10 h by NMP, SNMP or CS (n = 5/group)...
April 18, 2016: Artificial Organs
Laurens J Ceulemans, Sébastien Strypstein, Arne Neyrinck, Stijn Verleden, David Ruttens, Diethard Monbaliu, Paul De Leyn, Johan Vanhaecke, Bart Meyns, Frederik Nevens, Geert Verleden, Dirk Van Raemdonck, Jacques Pirenne
Combined liver/thoracic transplantation (cLiThTx) is a complex procedure for end-stage/advanced liver and heart(H)/lung(Lu) disease. To avoid futile use of multiple organs in single recipients, results should be scrutinously analyzed. Single-center cLiThTx (04/2000-12/2015) were reviewed for the following: demographics, indications, surgical technique, complications, rejection, and five-year patient survival. Results are reported as median (range). Fourteen consecutive patients underwent cLiThTx: 3 cLiHTx, 10 cLiLuTx, and 1 cLiHLuTx...
June 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
Babak Banan, Rao Watson, Min Xu, Yiing Lin, William Chapman
Donor organ shortages have led to an increased interest in finding new approaches to recover organs from extended criteria donors (ECD). Normothermic extracorporeal liver perfusion (NELP) has been proposed as a superior preservation method to reduce ischemia/reperfusion injury (IRI), precondition suboptimal grafts, and treat ECD livers so that they can be successfully used for transplantation. The aim of this study was to investigate the beneficial effects of a modified NELP circuit on discarded human livers...
July 2016: Liver Transplantation
Sanna Op den Dries, Negin Karimian, Andrie C Westerkamp, Michael E Sutton, Michiel Kuipers, Janneke Wiersema-Buist, Petra J Ottens, Jeroen Kuipers, Ben N Giepmans, Henri G D Leuvenink, Ton Lisman, Robert J Porte
Bile duct injury may occur during liver procurement and transplantation, especially in livers from donation after circulatory death (DCD) donors. Normothermic machine perfusion (NMP) has been shown to reduce hepatic injury compared to static cold storage (SCS). However, it is unknown whether NMP provides better preservation of bile ducts. The aim of this study was to determine the impact of NMP on bile duct preservation in both DCD and non-DCD livers. DCD and non-DCD livers obtained from Lewis rats were preserved for 3 hours using either SCS or NMP, followed by 2 hours ex vivo reperfusion...
July 2016: Liver Transplantation
Radhika Chadha, Mohammad Ayaz Hossain, Atul Bagul
No abstract text is available yet for this article.
2016: Expert Review of Medical Devices
Babak Banan, Zhenyu Xiao, Rao Watson, Min Xu, Jianluo Jia, Gundumi A Upadhya, Thalachallour Mohanakumar, Yiing Lin, William Chapman
Normothermic extracorporeal liver perfusion (NELP) can decrease ischemia/reperfusion injury to the greatest degree when cold ischemia time is minimized. Warm perfusion of cold-stored livers results in hepatocellular damage, sinusoidal endothelial cell (SEC) dysfunction, and Kupffer cell activation. However, the logistics of organ procurement mandates a period of cold preservation before NELP. The aim of this study was to determine the beneficial effects of gradual rewarming of cold-stored livers by placement on NELP...
March 2016: Liver Transplantation
Vinzent N Spetzler, Nicolas Goldaracena, Juan Echiverri, J Moritz Kaths, Kristine S Louis, Oyedele A Adeyi, Paul M Yip, David R Grant, Nazia Selzner, Markus Selzner
We developed a novel technique of subnormothermic ex vivo liver perfusion (SNEVLP) for the storage of liver grafts before transplantation. To test the safety of SNEVLP for the nonextended criteria grafts (standard grafts), we compared it to a control group with minimal cold static storage (CS) time. Heart-beating pig liver retrieval was performed. Grafts were either stored in cold unmodified University of Wisconsin solution (CS-1), in cold University of Wisconsin solution with ex vivo perfusion additives (CS-2), or preserved with a sequence of 3 hours CS and 3 hours SNEVLP (33°C), followed by orthotopic liver transplantation...
January 2016: Liver Transplantation
J Moritz Kaths, Vinzent N Spetzler, Nicolas Goldaracena, Juan Echeverri, Kristine S Louis, Daniel B Foltys, Mari Strempel, Paul Yip, Rohan John, Istvan Mucsi, Anand Ghanekar, Darius Bagli, Lisa Robinson, Markus Selzner
Kidney transplantation has become a well-established treatment option for patients with end-stage renal failure. The persisting organ shortage remains a serious problem. Therefore, the acceptance criteria for organ donors have been extended leading to the usage of marginal kidney grafts. These marginal organs tolerate cold storage poorly resulting in increased preservation injury and higher rates of delayed graft function. To overcome the limitations of cold storage, extensive research is focused on alternative normothermic preservation methods...
2015: Journal of Visualized Experiments: JoVE
S F Bagnenko, O N Reznik, A E Skvortsov, A V Lopota, N A Griaznov, V V Kharlamov
No abstract text is available yet for this article.
2015: Vestnik Khirurgii Imeni I. I. Grekova
Mohamed Bejaoui, Eirini Pantazi, Viviana De Luca, Arnau Panisello, Emma Folch-Puy, Georgina Hotter, Clemente Capasso, Claudiu T Supuran, Joan Roselló-Catafau, Joan Rosselló-Catafau
Carbonic anhydrases (CAs) are ubiquitous metalloenzymes that catalyze the reversible hydration of carbon dioxide to bicarbonate and a proton. CAs are involved in numerous physiological and pathological processes, including acid-base homeostasis, electrolyte balance, oxygen delivery to tissues and nitric oxide generation. Given that these processes are found to be dysregulated during ischemia reperfusion injury (IRI), and taking into account the high vulnerability of steatotic livers to preservation injury, we hypothesized a new role for CA as a pharmacological agent able to protect against ischemic damage...
2015: PloS One
Michael E Sutton, Sanna op den Dries, Negin Karimian, Pepijn D Weeder, Marieke T de Boer, Janneke Wiersema-Buist, Annette S H Gouw, Henri G D Leuvenink, Ton Lisman, Robert J Porte
Although normothermic machine perfusion of donor livers may allow assessment of graft viability prior to transplantation, there are currently no data on what would be a good parameter of graft viability. To determine whether bile production is a suitable biomarker that can be used to discriminate viable from non-viable livers we have studied functional performance as well as biochemical and histological evidence of hepatobiliary injury during ex vivo normothermic machine perfusion of human donor livers. After a median duration of cold storage of 6...
2014: PloS One
Rinaldo Bellomo, Bruno Marino, Graeme Starkey, Michael Fink, Bao Zhong Wang, Glenn M Eastwood, Leah Peck, Helen Young, Shane Houston, Alison Skene, Helen Opdam, Robert Jones
BACKGROUND: Donation after circulatory death (DCD) livers are at markedly increased risk of primary graft dysfunction and biliary tract ischaemia. Normothermic extracorporeal liver perfusion (NELP) may increase the ability to transplant DCD livers and may allow their use for artificial extracorporeal liver support of patients with fulminant liver failure. OBJECTIVE: We conducted two proof-of-concept experiments using human livers after DCD to assess the feasibility and functional efficacy of NELP over an extended period...
September 2014: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
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