Clearance of Transaminases During Normothermic Ex Vivo Liver Perfusion.
1Department of Transplant Surgery, University of Alberta, Edmonton, AB, Canada
2Department of Experimental Surgery, University of Alberta, Edmonton, AB, Canada
Meeting: 2017 American Transplant Congress
Abstract number: A171
Keywords: Liver grafts, Liver metabolism, Liver preservation, Machine preservation
Session Information
Session Name: Poster Session A: Ischemic Injury and Organ Preservation Session I
Session Type: Poster Session
Date: Saturday, April 29, 2017
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Hall D1
One of the most promising applications of normothermic ex vivo liver perfusion is the possibility of real-time graft viability assessment. Many liver biomarkers are considered potential candidates, however, none have been validated in the clinical setting.
Purpose: Our aim was to further elucidate the behaviour of liver biochemical markers during normothermic ex vivo perfusion.
Methods: A concentrated liver transaminase solution was prepared by homogenizing liver tissue, freezing the supernatant, with multiple verifications performed to ensure stability of enzyme activity (AST, ALT, LD, ALP, total bilirubin). The AST value in the stock supernatant was measured to be 107, 000 U/L. Three experimental livers were perfused ex vivo for 48 hours each, and compared to three similar controls. In the experimental group, after stable perfusion was established, the circuit perfusate was injected with the prepared transaminase solution to artificially raise the circuit AST to a target level to 7,500 U/L. Over the duration of all perfusions, samples were taken at two hour intervals, and analyzed for AST, ALT, ALP, LD, total bilirubin lactate levels and graft oxygen consumption.
Results: Compared to controls, the treated liver perfusions demonstrated a significant abrupt spike in liver transaminases, (p=0.01), which decreased over time, but never to control baseline. Liver function, as evidenced by perfusion parameters, lactate clearance, oxygen consumption and bile production was not statistically different between groups.
Conclusion: The supplementation of an ex vivo liver circuit perfusate with exogenous transaminases does not effect graft function or viability. High levels of transaminases and LDH clear after several hours of perfusion, suggesting preserved endogeonous liver metabolism. Such tolerance tests may provide valuable indicators of prospective graft function.
CITATION INFORMATION: Bral M, Aboelnazar N, Gala-Lopez B, Hatami S, Freed D, Shapiro A. Clearance of Transaminases During Normothermic Ex Vivo Liver Perfusion. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Bral M, Aboelnazar N, Gala-Lopez B, Hatami S, Freed D, Shapiro A. Clearance of Transaminases During Normothermic Ex Vivo Liver Perfusion. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/clearance-of-transaminases-during-normothermic-ex-vivo-liver-perfusion/. Accessed November 24, 2024.« Back to 2017 American Transplant Congress