Subnormothermic machine perfusion (SNMP) alleviate hepatoceller injury during organ preservation. However more oxygen is required when perfusate SNMP. Some studies demonstrated that SNMP with hemoglobin-based oxygen carriers (HBOCs) should be improved oxygen metabolism. So, we used artificial red cells (Hb vesicles, HbV) as HBOCs, which encapsulate Hb solution in phospholipid vesicles, mimicking the cellular structure of RBCs.

【Aim】The aim of this study was to evaluate the efficacy of the perfusate with HbV under SNMP in cardiac death (DCD) donor pig model.

【Materials and methods】 We developed an organ preservation system with temperature controlled machine perfusion. In this experiment, pig livers were procured under warm ischemic times for 60 minutes and preserved 3 groups (preservation phase, as follows) for 4 hours. The preservation conditions were as follows: 4[deg] cold storage (Group1, N=3), SNMP(21[deg]) with University of Wisconsin (UW) perfusate only (Group2, N=4), SNMP with UW and HbV (Hb; 1.8mg/dl) perfusate (Group3, N=5). All livers were perfusated for 2 hours using pig autologous blood machine perfusion (reperfusion phase). We investigated AST, LDH, lactate in perfusate and histological findings (Hematoxylin-Eosin, HE) during preservation and reperfusion phase.

【Results】During preservation and reperfusion phase, Group3 AST was suppressed compared with Group1, 2. AST in reperfusion 30min were 3757±1019 (Group1), 1150±186 (Group2), 804±237 (Group3) IU/L. In reperfusion 30min. Group 4 had significantly lower AST (p<0.05) compared with Group 1, 2, 3. During reperfusion 2hours, lactate were 11.2±0.8 (Group1), 7.1±0.6(Group2), 7.1±2.7 (Group3). Group2 and 3 had significantly lower lactate (p<0.05) compared with Group 1. Histologically, The Group3 had weak liver cell damage of Zone 2-3 and enlarged Disses space and edematous around Glisson capsulecompared Group1, 2.

【Conclusion】SNMP with UW and HbV perfusate could alleviate hepatocellular reperfusion injury of donor liver. SNMP can attenuate the metabolic disorder of the donor liver.

CITATION INFORMATION: Shonaka T., Matsuno N., Obara H., Yoshikawa R., Nishikawa Y., Gochi M., Otani M., Takahashi H., Azuma H., Sakai H., Furukawa H. Subnormothermic Machine Perfusion (SNMP) with Human Hemoglobin(Hb)-Based Oxygen Carriers (HBOCs)perfusate Decreased Hepatocellular Reperfusion Injury of Donation after Cardiac Death (DCD) Donor in Pig Model Am J Transplant. 2017;17 (suppl 3).

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