Objective Assessment of Graft Metabolism and Function During Ex Vivo Liver Perfusion.
1Multi-Organ Transplant Program, Department of Surgery, University of Toronto - Toronto General Hospital, Toronto, ON, Canada
2Multi-Organ Transplant Program, Department of Anesthesia, University of Toronto - Toronto General Hospital, Toronto, ON, Canada
3Multi-Organ Transplant Program, Department of Pathology, University of Toronto - Toronto General Hospital, Toronto, ON, Canada
4Multi-Organ Transplant Program, Department of Medicine, University of Toronto - Toronto General Hospital, Toronto, ON, Canada
Meeting: 2017 American Transplant Congress
Abstract number: D59
Keywords: Donors, Ischemia, Liver preservation, non-heart-beating, Warm ischemia
Session Information
Session Name: Poster Session D: Ischemic Injury and Organ Preservation Session III
Session Type: Poster Session
Date: Tuesday, May 2, 2017
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall D1
During EVLP no objective perfusion parameters have been found to predict outcome after transplantation.
Methods: Livers with 4grades of injury were perfused for 4 hours and transplanted into pigs. 4 groups(n=5 each)were compared: HBD, DCD30`WIT, DCD70`WIT, DCD120`WIT. Rocuronium clearance was assessed during EVLP and post transplant. EVLP lactate clearance, AST, bile production and hemodynamics were assessed. In recipients, liver injury and function were assessed by AST, ALT, alkaline phosphatase, total bilirubin, and INRuntil POD3.
Results: Significant injury led to higher intrahepatic resistance. Lactate clearance and bile production were enhanced in grafts with less injury. ASTlevels were higher in grafts with increased injury
. Rocuronium levels were higher in grafts with severe injury during EVLP and postreperfusion. All pigs survived until POD3. HBD and DCD30`WIT grafts had decreased postoperative ALT, INR, alkaline phosphatase, and bilirubin levels.
Conclusion: Hemodynamic parameters, bile production, lactate and rocuronium clearance during EVLP correlate with post transplant function.The creation of an objective score to evaluate grafts during EVLP is yet to be evaluated in the clinical setting.
CITATION INFORMATION: Echeverri J, Cleland S, Kaths M, Linares I, Roizales R, Goldaracena N, Kollmann D, Hamar M, Urbanellis P, Ganesh S, Adeyi O, Grant D, Selzner N, Wasowicz M, Selzner M. Objective Assessment of Graft Metabolism and Function During Ex Vivo Liver Perfusion. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Echeverri J, Cleland S, Kaths M, Linares I, Roizales R, Goldaracena N, Kollmann D, Hamar M, Urbanellis P, Ganesh S, Adeyi O, Grant D, Selzner N, Wasowicz M, Selzner M. Objective Assessment of Graft Metabolism and Function During Ex Vivo Liver Perfusion. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/objective-assessment-of-graft-metabolism-and-function-during-ex-vivo-liver-perfusion/. Accessed November 22, 2024.« Back to 2017 American Transplant Congress