Abstract
I motsats till konventionell statisk kall konservering (0-4 ° C), kan ex situ maskin perfusion ge bättre bevarande av givar lever. Kontinuerlig perfusion av organ ger möjlighet att förbättra organkvalitet och medger ex situ livskraft bedömning av givar lever före transplantation. Denna video artikeln ger en steg för steg-protokoll för ex situ normotermisk maskin perfusion (37 ° C) av humana givar lever med hjälp av en anordning som ger ett tryck och temperaturkontrollerad pulserande perfusion av leverartären och kontinuerlig perfusion av portalen ven. Perfusionsfluidumet syresätts av två hålfibermembran oxygenatorer och temperaturen kan regleras mellan 10 ° C och 37 ° C. Under perfusion, kan bedömas den metaboliska aktiviteten i levern samt graden av skada genom biokemisk analys av prover tagna från organgenomströmningsfluiden. Maskin perfusion är ett mycket lovande verktygför att öka antalet av levrar som är lämpliga för transplantation.
Materials
Name | Company | Catalog Number | Comments |
Liver Assist | Organ Assist | OA.Li.Li.140 | Perfusion device |
Liver Assist disposable package | Organ Assist | OA.Li.DP.540 | Disposable set and cannulas |
Meredith No.8 | Vygon Nederlands B.V. | 1362082 | Bile duct cannula |
Human albumin 200 g/L / ALBUMAN | Sanquin | 15522598 | 100 ml |
Modified parenteral nutrition | Baxter Nederland B.V. | N14G30E | 7.35 ml |
Multivitamins for infusion / CERNEVIT | Baxter International Inc. | 9800927 | 7 μl |
Concentrated trace elements for infusion / NUTRITRACE | B. Braun Melsungen AG | 14811332 | 7.35 ml |
Metronidazole 5 mg/ml | Baxter Nederland B.V. | 98181882 | 40 ml |
Cefazoline / SERVAZOLIN | Sandoz B.V. | 15611337 | 2 ml |
Fast acting insulin | various vendors | 20 ml | |
Calcium glubionate, intravenous solution 10%, 137.5 mg/ml | Sandoz | 97038695 | 40 ml |
Sterile H2O | Fresenius Kabi Nederland B.V. | 98084453 | 51.3 ml |
NaCl 0.9% | Baxter Nederland B.V. | 15262510 | 160 ml |
Heparin 5,000 IE/ml for i.v. administration | LEO Pharma B.V. | 98026178 | 4 ml |
Sodium bicarbonate 8.4% | B. Braun Melsungen AG | 97973874 | The amount depends on the pH |
Packed red blood cell (in SAGM) | Blood bank (Sanquin) | N0012000 | 750 ml |
Fresh frozen plasma | Blood bank (Sanquin) | N04030A0/N04030B0 | 900 ml |
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