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Normothermic Ex vivo liver perfusion

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https://www.readbyqxmd.com/read/28240817/liver-ex-vivo-machine-perfusion-preservation-a-review-of-the-methodology-and-results-of-large-animal-studies-and-clinical-trials
#1
REVIEW
Hazel Marecki, Adel Bozorgzadeh, Robert Porte, Henri Leuvenink, Korkut Uygun, Paulo Martins
Ex-vivo machine perfusion is a promising way to better preserve livers prior to transplantation. Currently, no methodology has verified benefit over simple cold storage. Before becoming clinically feasible, machine perfusion requires validation in models that reliably predict human performance. Such a model has been found in porcine liver, who's physiological, anatomical, and immunological characteristics closely resemble the human liver. Since the 1930s, researchers have explored machine perfusion as preservation, but only recently have clinical trials been performed...
February 27, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/27941437/activation-of-fibrinolysis-but-not-coagulation-during-end-ischemic-ex-situ-normothermic-machine-perfusion-of-human-donor-livers
#2
Shanice A Karangwa, Laura C Burlage, Jelle Adelmeijer, Negin Karimian, Andrie C Westerkamp, Alix P Matton, Rianne van Rijn, Janneke Wiersema-Buist, Micheal E Sutton, Sanna Op den Dries, Ton Lisman, Robert J Porte
BACKGROUND: Ex situ normothermic machine perfusion (NMP) can be performed after traditional static cold preservation to assess graft function and viability before transplantation. It is unknown whether this results in activation of coagulation and fibrinolysis, as may occur upon graft reperfusion in vivo. METHODS: Twelve donor livers declined for transplantation underwent 6 hours of end-ischemic NMP using a heparinized plasma-based perfusion fluid. Concentration of prothrombin fragment F1 + 2 (marker of coagulation activation), D-dimer, plasmin-antiplasmin complex, tissue plasminogen activator and plasminogen activator inhibitor-1 (markers for fibrinolysis) and alanine aminotransferase (ALT) (marker of ischemia-reperfusion [I/R] injury) were measured in perfusion fluid at regular intervals...
February 2017: Transplantation
https://www.readbyqxmd.com/read/27805315/inducing-hepatitis-c-virus-resistance-after-pig-liver-transplantation-a-proof-of-concept-of-liver-graft-modification-using-warm-ex-vivo-perfusion
#3
N Goldaracena, V N Spetzler, J Echeverri, J M Kaths, V Cherepanov, R Persson, M R Hodges, H L A Janssen, N Selzner, D R Grant, J J Feld, M Selzner
Normothermic ex vivo liver perfusion (NEVLP) offers the potential to optimize graft function prior to liver transplantation (LT). Hepatitis C virus (HCV) is dependent on the presence of miRNA(microRNA)-122. Miravirsen, a locked-nucleic acid oligonucleotide, sequesters miR-122 and inhibits HCV replication. The aim of this study was to assess the efficacy of delivering miravirsen during NEVLP to inhibit miR-122 function in a pig LT model. Pig livers were treated with miravirsen during NEVLP or cold storage (CS)...
April 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/27771093/normothermic-ex-vivo-liver-perfusion-from-donors-after-type-2-cardiac-arrest
#4
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
https://www.readbyqxmd.com/read/27639262/preliminary-single-center-canadian-experience-of-human-normothermic-ex-vivo-liver-perfusion-results-of-a-clinical-trial
#5
M Bral, B Gala-Lopez, D Bigam, N Kneteman, A Malcolm, S Livingstone, A Andres, J Emamaullee, L Russell, C Coussios, L J West, P J Friend, A M J Shapiro
After extensive experimentation, outcomes of a first clinical normothermic machine perfusion (NMP) liver trial in the United Kingdom demonstrated feasibility and clear safety, with improved liver function compared with standard static cold storage (SCS). We present a preliminary single-center North American experience using identical NMP technology. Ten donor liver grafts were procured, four (40%) from donation after circulatory death (DCD), of which nine were transplanted. One liver did not proceed because of a technical failure with portal cannulation and was discarded...
April 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/27556578/anti-inflammatory-signaling-during-ex-vivo-liver-perfusion-improves-the-preservation-of-pig-liver-grafts-before-transplantation
#6
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
Normothermic ex vivo liver perfusion (NEVLP) improves graft preservation by avoiding cold ischemia injury. We investigated whether the protective effects of NEVLP can be further improved by applying strategies targeted on reducing the activation of proinflammatory cytokines during perfusion. Livers retrieved under heart-beating conditions were perfused for 4 hours. Following the preservation period, a pig liver transplantation was performed. In group 1 (n = 5), anti-inflammatory strategies (alprostadil, n-acetylcysteine, carbon monoxide, sevoflurane, and subnormothermic temperature [33°C]) were applied...
November 2016: Liver Transplantation
https://www.readbyqxmd.com/read/27402131/expanding-the-donor-pool-with-normothermic-ex-vivo-liver-perfusion-the-future-is-now
#7
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
https://www.readbyqxmd.com/read/27339754/normothermic-ex-vivo-liver-perfusion-using-steen-solution-as-perfusate-for-human-liver-transplantation-first-north-american-results
#8
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, a non-US Food and Drug Administration-approved, bovine-derived, gelatin-based perfusion solution. We report a safety and feasibility clinical NEVLP trial with human albumin-based Steen solution. Transplant outcomes of 10 human liver grafts that were perfused on the Metra device at 37 °C with Steen solution, plus 3 units of erythrocytes were compared with a matched historical control group of 30 grafts using cold storage (CS) as the preservation technique...
November 2016: Liver Transplantation
https://www.readbyqxmd.com/read/27295096/26-hour-storage-of-a-declined-liver-before-successful-transplantation-using-ex-vivo-normothermic-perfusion
#9
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.
January 2017: Annals of Surgery
https://www.readbyqxmd.com/read/27158081/ex-vivo-liver-perfusion-for-organ-preservation-recent-advances-in-the-field
#10
REVIEW
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
https://www.readbyqxmd.com/read/27093224/normothermic-and-subnormothermic-ex-vivo-liver-perfusion-in-liver-transplantation
#11
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
https://www.readbyqxmd.com/read/27086771/impact-of-temperature-on-porcine-liver-machine-perfusion-from-donors-after-cardiac-death
#12
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)...
October 2016: Artificial Organs
https://www.readbyqxmd.com/read/27037837/combined-liver-thoracic-transplantation-single-center-experience-with-introduction-of-the-liver-first-principle
#13
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
https://www.readbyqxmd.com/read/27027254/development-of-a-normothermic-extracorporeal-liver-perfusion-system-toward-improving-viability-and-function-of-human-extended-criteria-donor-livers
#14
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
https://www.readbyqxmd.com/read/26946466/normothermic-machine-perfusion-reduces-bile-duct-injury-and-improves-biliary-epithelial-function-in-rat-donor-livers
#15
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
https://www.readbyqxmd.com/read/26808702/optimising-organs-for-transplantation-is-normothermic-machine-perfusion-the-answer
#16
EDITORIAL
Radhika Chadha, Mohammad Ayaz Hossain, Atul Bagul
No abstract text is available yet for this article.
2016: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/26439190/novel-strategy-to-decrease-reperfusion-injuries-and-improve-function-of-cold-preserved-livers-using-normothermic-ex-vivo-liver-perfusion-machine
#17
COMPARATIVE STUDY
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
https://www.readbyqxmd.com/read/26390093/subnormothermic-ex-vivo-liver-perfusion-is-a-safe-alternative-to-cold-static-storage-for-preserving-standard-criteria-grafts
#18
COMPARATIVE STUDY
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
https://www.readbyqxmd.com/read/26275014/normothermic-ex-vivo-kidney-perfusion-for-the-preservation-of-kidney-grafts-prior-to-transplantation
#19
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
https://www.readbyqxmd.com/read/26234082/-relevance-of-normothermic-ex-vivo-perfusion-of-the-liver-in-transplantation
#20
REVIEW
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
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