Search results for "Liver preservation"
showing 6 items of 6 documents
Comparative analysis of in situ versus ex situ perfusion on micro circulation in liver procurement--an experimental trial in a porcine model.
2012
The Achilles heel of liver transplantation remains the biliary system. The crucial step for liver preservation is effective rinsing and perfusion of the peribiliary plexus (PBP). Due to the physiology of the vascular tree, it seems almost impossible to achieve the necessary physiologic ranges of pressure and flow by the in situ perfusion technique. We investigated the role of additional ex situ perfusion via the hepatic artery in this animal model.Fifteen German Landrace pigs underwent standardized multiorgan procurement. In situ perfusion and additional ex situ perfusion were performed consecutively. Meanwhile the external pressure applied to the perfusion system was increased stepwise. To…
Flow and Pressure during Liver Preservation under ex situ and in situ Perfusion with University of Wisconsin Solution and Histidine-Tryptophan-Ketogl…
2006
Effective preservation of liver grafts is the first essential step for successful liver transplantation. Insufficient perfusion leads to ischemic-type biliary lesions after transplantation. Perfusion of the graft can be performed either in situ or ex situ, with gravity flow or pressure-controlled. Mainly University of Wisconsin (UW) and histidine-tryptophan-ketoglutarate (HTK) solutions are used widespread in clinical liver transplantation. Due to a persistent lack of data, we performed this systematic investigation of in situ and ex situ perfusion of liver grafts with HTK (low-viscous) and UW (high-viscous) solutions at different pressure steps on the perfusion solution (gravity flow, 50, …
Hypothermic Oscillating Liver Perfusion Stimulates ATP Synthesis prior to Transplantation
1998
Abstract Background. ATP and glycogen depletion often have been demonstrated during cold storage of the liver prior to transplantation. Suppression of events that lead to metabolic depression and to lipid peroxidation could contribute to improvement of liver preservation. A new method of liver preservation for transplantation is therefore suggested, an oscillating oxygenated hypothermic liver perfusion. Methods. Biochemical analysis of liver tissue samples and perfusate after 10 h of perfusion by the presented oscillating perfusion model were compared with results after continuous liver perfusion for 10 h as well as with data derived from cold-stored livers over a period of 10 h. Particular…
REDUCED OXIDATIVE STRESS DURING ACELLULAR REPERFUSION OF THE RAT LIVER AFTER HYPOTHERMIC OSCILLATING PERFUSION
1999
Background ATP resynthesis during reperfusion after liver preservation has been shown to be well correlated with the function of transplanted grafts. Nevertheless, the advantages of a cellular energy charge loading during the preservation period are yet not fully understood. This study evaluates the effects of different nucleotide levels at the end of preservation on metabolic changes and oxidative stress during reperfusion. Methods Two experimental groups were chosen reflecting different energy charge states after preservation: static cold storage for 10 hr and hypothermic oxygenated oscillating perfusion for 10 hr. In both experimental groups, normothermic ex vivo acellular reperfusion ov…
Liver Preservation by Aortic Perfusion Alone Compared With Preservation by Aortic Perfusion and Additional Arterial Ex Situ Back-Table Perfusion With…
2017
Background. Arterial ex situ back-table perfusion (BP) reportedly reduces ischemic-type biliary lesion after liver transplantation. We aimed to verify these findings in a prospective investigation. Methods. Our prospective, randomized, controlled, multicenter study involved livers retrieved from patients in 2 German regions, and compared the outcomes of standard aortic perfusion to those of aortic perfusion combined with arterial ex situ BP. The primary endpoint was the incidence of ischemic-type biliary lesions over a follow-up of 2 years after liver transplantation, whereas secondary endpoints included 2-year graft survival, initial graft damage as reflected by transaminase levels, and fu…
Beeinflussung des Leberzellmetabolismus, der Freisetzung von reaktiven Sauerstoffspezies sowie Apoptoseaktivierung durch hypotherme oxygenierte Leber…
2003
Two different methods of liver preservation were compared : simple cold storage (CS) and hypothermic oxygenated perfusion extracorporal (HOPE). After 10 h of preservation (4°C) with modified UW solution reperfusion was performed by isolated liver perfusion for 90 minutes. Reperfusion injury was estimated by release of cytosolic enzymes, formation of superoxide anions, determination of lipid peroxidation, glycolytic metabolites, bileflow and by PCR analysis. The results showed that after cold storage the formation of reactive oxygen species was significant higher as compared with perfused livers. Correspondingly expressions of mediators (TNFα, NF kappa B, MIP-2, SAPK) and apoptosis (Caspase …