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Extracorporeal membrane oxygenation for resuscitation of deceased cardiac donor livers for hepatocyte isolation

Lookup NU author(s): Mohamed Noormohamed, Professor Matthew Wright, Dr David Cowie, Susan Stamp, David Talbot, Professor Derek Manas, Steven White

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Abstract

Background Deceased cardiac donors (DCDs) have become a useful source of organs for liver transplantation; nevertheless, there are concerns about the longevity of these grafts. The aim of this study was to evaluate the use of extracorporeal membrane oxygenation (ECMO) to resuscitate DCD porcine livers as a preclinical model using hepatocyte isolation and viability as a marker to assess whole-graft preservation. Materials and methods We randomized Landrace pigs into three groups after cardiac death and 30 min of warm ischemia: group 1, peritoneal cooling with intravascular cooling for 2 h; group 2, ECMO for 2 h; and group 3, control (conventional intravascular cooling and retrieval). We then reperfused group 1 and 2 livers for 2 h on an ex vivo reperfusion circuit and isolated hepatocytes. Results After reperfusion, hepatocyte viability was significantly improved in the ECMO group compared to the cooling groups, as measured by trypan blue, methylthiazolyldiphenyl-tetrazolium bromide, and seeding efficiency. Glycogen and reduced glutathione content were significantly used in the ECMO group both before and after reperfusion compared with group 2. The adenosine diphosphate:adenosine triphosphate ratio showed an improved trend (lower) in the ECMO group compared with the cooling group but did not reach statistical significance either before or after reperfusion. Conclusions This preclinical study suggests that ECMO is a viable technique for liver preservation that gives an improved yield of hepatocytes when isolated from a DCD liver, suggesting improved liver preservation.

Publication metadata

Author(s): Noormohamed MS, Kanwar A, Ray C, Wright MC, Cowie DE, Stamp S, Talbot D, Manas D, White SA

Publication type: Article

Publication status: Published

Journal: Journal of Surgical Research

Year: 2013

Volume: 183

Issue: 2

Pages: e39-e48

Print publication date: 01/08/2013

ISSN (print): 0022-4804

ISSN (electronic): 1095-8673

Publisher: Academic Press

URL: http://dx.doi.org/10.1016/j.jss.2013.03.026

DOI: 10.1016/j.jss.2013.03.026

PubMed id: 23647801

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