Normothermic Machine Perfusion of Donor Livers Without the Need for Human Blood Products

Alix P M Matton; Laura C Burlage; Rianne van Rijn; Yvonne de Vries; Shanice A Karangwa; Maarten W Nijsten; Annette S H Gouw; Janneke Wiersema-Buist; Jelle Adelmeijer; Andrie C Westerkamp; Ton Lisman; Robert J Porte

doi:10.1002/lt.25005

Normothermic Machine Perfusion of Donor Livers Without the Need for Human Blood Products

Alix P M Matton, Laura C Burlage, Rianne van Rijn, Yvonne de Vries, Shanice A Karangwa, Maarten W Nijsten, Annette S H Gouw, Janneke Wiersema-Buist, Jelle Adelmeijer, Andrie C Westerkamp, Ton Lisman, Robert J Porte

Onderzoeksoutput › Academic › peer review

61 Citaten (Scopus)

546 Downloads (Pure)

Samenvatting

BACKGROUND: Normothermic machine perfusion (NMP) enables viability assessment of donor livers prior to transplantation. NMP is frequently performed using human blood products including red blood cells (RBC) and fresh frozen plasma (FFP). Our aim was to examine the efficacy of a novel machine perfusion solution based on polymerized bovine hemoglobin HBOC-201.

METHODS: Twenty-four livers declined for transplantation were transported using static cold storage. Upon arrival, livers underwent NMP for 6 hours using pressure-controlled portal and arterial perfusion. Twelve livers were perfused using a solution based on RBCs and FFPs (historical cohort), 6 livers with HBOC-201 and FFPs, and another 6 livers with HBOC-201 and Gelofusine, a gelatin-based colloid solution.

RESULTS: Compared to RBC + FFP perfused livers, livers perfused with HBOC-201 had significantly higher hepatic ATP content, cumulative bile production and portal and arterial flows. Biliary secretion of bicarbonate, bilirubin, bile salts, and phospholipids was similar in all three groups. The ALT concentration in perfusate was lower in HBOC-201 perfused groups.

CONCLUSION: NMP of human donor livers can be performed effectively using HBOC-201 and Gelofusine, eliminating the need for human blood products. Perfusing livers with HBOC-201 is at least similar to perfusion with RBCs and FFPs. Some of the biomarkers of liver function and injury even suggest a possible superiority of an HBOC-201 based perfusion solution and opens a perspective for further optimization of machine perfusion techniques. This article is protected by copyright. All rights reserved.

Originele taal-2	English
Pagina's (van-tot)	528-538
Aantal pagina's	11
Tijdschrift	Liver Transplantation
Volume	24
Nummer van het tijdschrift	4
Vroegere onlinedatum	27-dec-2017
DOI's	https://doi.org/10.1002/lt.25005
Status	Published - apr-2018

Toegang tot document

10.1002/lt.25005Licentie: CC BY-NC-ND

Normothermic machine perfusion of donor liversFinal publisher's version, 775 KBLicentie: CC BY-NC-ND

Citeer dit

Matton, Alix P M ; Burlage, Laura C ; van Rijn, Rianne ; de Vries, Yvonne ; Karangwa, Shanice A ; Nijsten, Maarten W ; Gouw, Annette S H ; Wiersema-Buist, Janneke ; Adelmeijer, Jelle ; Westerkamp, Andrie C ; Lisman, Ton ; Porte, Robert J. / Normothermic Machine Perfusion of Donor Livers Without the Need for Human Blood Products. In: Liver Transplantation. 2018 ; Vol. 24, Nr. 4. blz. 528-538.

@article{c547f4a8c9df4b3d9dc56defef6a4a4c,

title = "Normothermic Machine Perfusion of Donor Livers Without the Need for Human Blood Products",

abstract = "BACKGROUND: Normothermic machine perfusion (NMP) enables viability assessment of donor livers prior to transplantation. NMP is frequently performed using human blood products including red blood cells (RBC) and fresh frozen plasma (FFP). Our aim was to examine the efficacy of a novel machine perfusion solution based on polymerized bovine hemoglobin HBOC-201.METHODS: Twenty-four livers declined for transplantation were transported using static cold storage. Upon arrival, livers underwent NMP for 6 hours using pressure-controlled portal and arterial perfusion. Twelve livers were perfused using a solution based on RBCs and FFPs (historical cohort), 6 livers with HBOC-201 and FFPs, and another 6 livers with HBOC-201 and Gelofusine, a gelatin-based colloid solution.RESULTS: Compared to RBC + FFP perfused livers, livers perfused with HBOC-201 had significantly higher hepatic ATP content, cumulative bile production and portal and arterial flows. Biliary secretion of bicarbonate, bilirubin, bile salts, and phospholipids was similar in all three groups. The ALT concentration in perfusate was lower in HBOC-201 perfused groups.CONCLUSION: NMP of human donor livers can be performed effectively using HBOC-201 and Gelofusine, eliminating the need for human blood products. Perfusing livers with HBOC-201 is at least similar to perfusion with RBCs and FFPs. Some of the biomarkers of liver function and injury even suggest a possible superiority of an HBOC-201 based perfusion solution and opens a perspective for further optimization of machine perfusion techniques. This article is protected by copyright. All rights reserved.",

keywords = "CIRCULATORY DEATH, OXYGEN CARRIER, TRANSPLANTATION, PRESERVATION, INJURY, BILE",

author = "Matton, {Alix P M} and Burlage, {Laura C} and {van Rijn}, Rianne and {de Vries}, Yvonne and Karangwa, {Shanice A} and Nijsten, {Maarten W} and Gouw, {Annette S H} and Janneke Wiersema-Buist and Jelle Adelmeijer and Westerkamp, {Andrie C} and Ton Lisman and Porte, {Robert J}",

note = "{\textcopyright} 2017 by the American Association for the Study of Liver Diseases.",

year = "2018",

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doi = "10.1002/lt.25005",

language = "English",

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pages = "528--538",

journal = "Liver Transplantation",

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Normothermic Machine Perfusion of Donor Livers Without the Need for Human Blood Products. / Matton, Alix P M; Burlage, Laura C; van Rijn, Rianne; de Vries, Yvonne; Karangwa, Shanice A; Nijsten, Maarten W ; Gouw, Annette S H ; Wiersema-Buist, Janneke; Adelmeijer, Jelle; Westerkamp, Andrie C; Lisman, Ton ; Porte, Robert J.

In: Liver Transplantation, Vol. 24, Nr. 4, 04.2018, blz. 528-538.

Onderzoeksoutput › Academic › peer review

TY - JOUR

T1 - Normothermic Machine Perfusion of Donor Livers Without the Need for Human Blood Products

AU - Matton, Alix P M

AU - Burlage, Laura C

AU - van Rijn, Rianne

AU - de Vries, Yvonne

AU - Karangwa, Shanice A

AU - Nijsten, Maarten W

AU - Gouw, Annette S H

AU - Wiersema-Buist, Janneke

AU - Adelmeijer, Jelle

AU - Westerkamp, Andrie C

AU - Lisman, Ton

AU - Porte, Robert J

PY - 2018/4

Y1 - 2018/4

N2 - BACKGROUND: Normothermic machine perfusion (NMP) enables viability assessment of donor livers prior to transplantation. NMP is frequently performed using human blood products including red blood cells (RBC) and fresh frozen plasma (FFP). Our aim was to examine the efficacy of a novel machine perfusion solution based on polymerized bovine hemoglobin HBOC-201.METHODS: Twenty-four livers declined for transplantation were transported using static cold storage. Upon arrival, livers underwent NMP for 6 hours using pressure-controlled portal and arterial perfusion. Twelve livers were perfused using a solution based on RBCs and FFPs (historical cohort), 6 livers with HBOC-201 and FFPs, and another 6 livers with HBOC-201 and Gelofusine, a gelatin-based colloid solution.RESULTS: Compared to RBC + FFP perfused livers, livers perfused with HBOC-201 had significantly higher hepatic ATP content, cumulative bile production and portal and arterial flows. Biliary secretion of bicarbonate, bilirubin, bile salts, and phospholipids was similar in all three groups. The ALT concentration in perfusate was lower in HBOC-201 perfused groups.CONCLUSION: NMP of human donor livers can be performed effectively using HBOC-201 and Gelofusine, eliminating the need for human blood products. Perfusing livers with HBOC-201 is at least similar to perfusion with RBCs and FFPs. Some of the biomarkers of liver function and injury even suggest a possible superiority of an HBOC-201 based perfusion solution and opens a perspective for further optimization of machine perfusion techniques. This article is protected by copyright. All rights reserved.

AB - BACKGROUND: Normothermic machine perfusion (NMP) enables viability assessment of donor livers prior to transplantation. NMP is frequently performed using human blood products including red blood cells (RBC) and fresh frozen plasma (FFP). Our aim was to examine the efficacy of a novel machine perfusion solution based on polymerized bovine hemoglobin HBOC-201.METHODS: Twenty-four livers declined for transplantation were transported using static cold storage. Upon arrival, livers underwent NMP for 6 hours using pressure-controlled portal and arterial perfusion. Twelve livers were perfused using a solution based on RBCs and FFPs (historical cohort), 6 livers with HBOC-201 and FFPs, and another 6 livers with HBOC-201 and Gelofusine, a gelatin-based colloid solution.RESULTS: Compared to RBC + FFP perfused livers, livers perfused with HBOC-201 had significantly higher hepatic ATP content, cumulative bile production and portal and arterial flows. Biliary secretion of bicarbonate, bilirubin, bile salts, and phospholipids was similar in all three groups. The ALT concentration in perfusate was lower in HBOC-201 perfused groups.CONCLUSION: NMP of human donor livers can be performed effectively using HBOC-201 and Gelofusine, eliminating the need for human blood products. Perfusing livers with HBOC-201 is at least similar to perfusion with RBCs and FFPs. Some of the biomarkers of liver function and injury even suggest a possible superiority of an HBOC-201 based perfusion solution and opens a perspective for further optimization of machine perfusion techniques. This article is protected by copyright. All rights reserved.

KW - CIRCULATORY DEATH

KW - OXYGEN CARRIER

KW - TRANSPLANTATION

KW - PRESERVATION

KW - INJURY

KW - BILE

U2 - 10.1002/lt.25005

DO - 10.1002/lt.25005

M3 - Article

C2 - 29281862

VL - 24

SP - 528

EP - 538

JO - Liver Transplantation

JF - Liver Transplantation

SN - 1527-6465

IS - 4

ER -