The importance of adequate oxygenation during hypothermic machine perfusion

Abstract

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Prolonged preservation by hypothermic machine perfusion facilitates logistics in liver transplantation: A European observational cohort study

“…The median recipient age was 59 (53-65) years and the majority was male (78%). Prior to liver transplantation, the median BAR score was 5 (3)(4)(5)(6)(7)(8). The most common indications for liver transplantation were alcoholic cirrhosis (22%), hepatocellular carcinoma (17%), and nonalcoholic steatohepatitis (16%).…”

“…Hypothermic oxygenation of mitochondria induces metabolic programming within 1 h, thereby decreasing mitochondrial succinate accumulation and uploading adenosine triphosphate levels 2 . Reperfusion of livers treated by end‐ischemic HOPE is, therefore, associated with less oxidative injury and mitochondrial damage with subsequently less downstream inflammation 2‐4 …”

Oxygen Transport during Ex Situ Machine Perfusion of Donor Livers Using Red Blood Cells or Artificial Oxygen Carriers

“…The initial transplantation-related research was performed by Thuillier et al They demonstrated that Hemarina M101 has a beneficial effect during SCS before kidney transplantation by decreasing chronic fibrosis and organ dysfunction [ 82 ]. Alix et al compared SCS solution with Hemarina M101 versus SCS solution alone during porcine liver graft preservation, showing higher ATP levels in the SCS with Hemarina M101 group after 80 min [ 42 , 83 ]. M101 was also used in preclinical trials as an additive to the perfusion solution during HMP in a marginal kidney porcine model.…”

“…The [42,83]. M101 was also used in preclinical trials as an additive to the perfusion solution during HMP in a marginal kidney porcine model.…”

Oxygenated versus non‐oxygenated flush out and storage of donor livers: An experimental study

“…End-ischemic preservation by HOPE, on the other hand, is able to restore ATP content by multifold. 21 The limited effect of an oxygenated flush on ATP could partly be explained by the short duration of oxygenation (only during several minutes of in situ donor flush compared with 1-2 h HOPE). Theoretically, the flush out time can be prolonged to enhance the effect of F I G U R E 4 Cholangiocellular function during 4 h of normothermic reperfusion.…”