Comparative study of preservative effect of normothermic machine perfusion on porcine liver with warm ischemia injury between portal vein pressure- and flow-controlled mode

Abstract

Abstract: Objective To compare the protective effect of portal vein pressure-controlled and flow-controlled mode in porcine livers with warm ischemia by normothermic machine perfusion (NMP) system ex vivo. Methods Female Bama miniature swine were used as both blood and liver donors. The livers with 60-minute warm ischemia time were divided into 2 groups, one group was perfused in a portal vein constant pressure-controlled mode (n = 6), the other was perfused in a portal vein constant flow-controlled mode (n = 6), each group was perfused for 6 hours with NMP equipment. The perfusion parameters, blood gas parameters, biochemical indicators, and histopathology of livers were analyzed. Results There was no statistical difference in cold ischemic time between the 2 groups before perfusion (P > 0.05). After 6 hours of NMP, the hepatic artery flow in the constant pressure-controlled group [(0.13 ± 0.08) mL/min/g (liver weight)] was lower than that in the constant flow-controlled group [(0.25 ± 0.09) mL/min/g (liver weight)] (P<0.05). Between the 2 groups, there was no difference in perfusate pH, lactate level, glucose level, and blood urea nitrogen level (except for the 2nd hour) (P>0.05). There was no statistical difference in hepatocellular enzymes or total bilirubin level between the 2 groups at the end of perfusion either (P>0.05). The volume of bile produced in the constant flow-controlled group [(54.47 ± 15.63) mL] was more than that in the constant pressure-controlled group [(6.98 ± 3.20) mL] (P<0.05). In hepatic histopathological score, there were no differences between the 2 groups (P>0.05). Conclusion The constant flow-controlled mode was more beneficial to the blood supply of hepatic artery, thus promoted the bile synthesis in liver. It is suggested that the portal vein flow-controlled mode may be a better perfusion method, which requires further animal liver transplantation experiments and clinical liver transplantation trials.

Key words: Normothermic machine perfusion, Miniature swine, Liver, Warm ischemia, Constant pressure-controlled, Constant flow-controlled

HE Xi-ran, TAN Xiao-yu, ZHANG Lin, KUANG Wei-jian, LIU Hua-min, CHEN Su-ping, GUO Jia-xing, LIANG Ming-ju, ZHOU Wei-jin, HUO Feng. Comparative study of preservative effect of normothermic machine perfusion on porcine liver with warm ischemia injury between portal vein pressure- and flow-controlled mode[J]. Chinese Hepatolgy, 2020, 25(8): 853-856.

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