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Medicine

Donör karaciğerleri Ex Situ Normotermik Makinesi Perfüzyonu

Published: May 26, 2015 doi: 10.3791/52688

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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References

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  2. op den Dries, S., Sutton, M. E., Lisman, Y., Porte, R. J. Protection of bile ducts in liver transplantation: Looking beyond ischemia. Transplantation. 92 (4), 373-379 (2011).
  3. Seehofer, D., Eurich, D., Veltzke-Schlieker, W., Neuhaus, P. Biliary complications after liver transplantation: Old problems and new challenges. Am. J. Transplant. 13 (2), 253-265 (2013).
  4. Buis, C. I., et al. Nonanastomotic biliary strictures after liver transplantation, part 1: Radiological features and risk factors for early vs. late presentation. Liver. Transpl. 13 (5), 708-718 (2007).
  5. Karimian, N., op den Dries, S., Porte, R. J. The origin of biliary strictures after liver transplantation: Is it the amount of epithelial injury or insufficient regeneration that counts. J. Hepatol. 58 (6), 1065-1067 (2013).
  6. Gastaca, M. Biliary complications after orthotopic liver transplantation: A review of incidence and risk factors. Transplant. Proc. 44 (6), 1545-1549 (2012).
  7. Sanchez-Urdazpal, L., et al. Ischemic-type biliary complications after orthotopic liver transplantation. Hepatology. 16 (1), 49-53 (1992).
  8. Dubbeld, J., et al. Similar liver transplantation survival with selected cardiac death donors and brain death donors. Br. J. Surg. 97 (5), 744-753 (2010).
  9. Guarrera, J. V., et al. Hypothermic machine preservation in human liver transplantation: The first clinical series. Am. J. Transplant. 10 (2), 372-381 (2010).
  10. Henry, S. D., et al. Hypothermic machine preservation reduces molecular markers of ischemia/reperfusion injury in human liver transplantation. Am. J. Transplant. 12 (9), 2477-2486 (2012).
  11. Schlegel, A., Rougemont, O., Graf, R., Clavien, P. A., Dutkowski, P. Protective mechanisms of end-ischemic cold machine perfusion in DCD liver grafts. J. Hepatol. 58 (2), 278-286 (2013).
  12. op den Dries, S., et al. Hypothermic oxygenated machine perfusion prevents arteriolonecrosis of the peribiliary plexus in pig livers donated after circulatory death. PLoS. One. 9 (2), e88521 (2014).
  13. Tolboom, H., et al. Subnormothermic machine perfusion at both 20 degrees C and 30 degrees C recovers ischemic rat livers for successful transplantation. J. Surg. Res. 175 (1), 149-156 (2012).
  14. Gringeri, E., et al. Subnormothermic machine perfusion for non-heart-beating donor liver grafts preservation in a swine model: A new strategy to increase the donor pool? Transplant. Proc. 44 (7), 2026-2028 (2012).
  15. Bruinsma, B. G., et al. Subnormothermic machine perfusion for ex vivo preservation and recovery of the human liver for transplantation. Am. J. Transplant. 14 (6), 1400-1409 (2014).
  16. op den Dries, S., et al. Ex vivo normothermic machine perfusion and viability testing of discarded human donor livers. Am. J. Transplant. 13 (5), 1327-1335 (2013).
  17. Sutton, M. E., et al. Criteria for viability assessment of discarded human donor livers during ex vivo normothermic machine perfusion. PLoS. One. 9 (11), (2014).
  18. Minor, T., Efferz, P., Fox, M., Wohlschlaeger, J., Luer, B. Controlled oxygenated rewarming of cold stored liver grafts by thermally graduated machine perfusion prior to reperfusion. Am. J. Transplant. 13 (6), 1450-1460 (2013).
  19. Makowka, L., et al. Surgical technique of orthotopic liver transplantation. Gastroenterol. Clin. North. Am. 17 (1), 33-51 (1988).
  20. Hansen, T., et al. Histological examination and evaluation of donor bile ducts received during orthotopic liver transplantation--a morphological clue to ischemic-type biliary lesion? Virchows Arch. 461 (1), 41-48 (2012).
  21. Monbaliu, D., Brassil, J. Machine perfusion of the liver: Past, present and future. Curr. Opin. Organ. Transplant. 15 (2), 160-166 (2010).
  22. Oldani, G., et al. Pre-retrieval reperfusion decreases cancer recurrence after rat ischemic liver graft transplantation. J. Hepatol. 61 (2), 278-285 (2014).
  23. Tromans, D. Temperature and pressure dependent solubility of oxygen in water: A thermodynamic analysis. Hydrometallurgy. 48 (3), 327-342 (1998).
Donör karaciğerleri <em>Ex Situ</em> Normotermik Makinesi Perfüzyonu
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Cite this Article

Karimian, N., Matton, A. P. M.,More

Karimian, N., Matton, A. P. M., Westerkamp, A. C., Burlage, L. C., op den Dries, S., Leuvenink, H. G. D., Lisman, T., Uygun, K., Markmann, J. F., Porte, R. J. Ex Situ Normothermic Machine Perfusion of Donor Livers. J. Vis. Exp. (99), e52688, doi:10.3791/52688 (2015).

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