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Adding Anti-Inflammatory Agents During Normothermic Ex-Vivo Liver Perfusion Improves the Preservation of Pig Liver Grafts Before Transplantation.

N. Goldaracena, E. Juan, K. Moritz, V. Spetzler, A. Barbas, D. Grant, M. Selzner.

Multi Organ Transplant Program, Toronto General Hospital, Toronto, Canada.

Meeting: 2016 American Transplant Congress

Abstract number: C117

Keywords: Machine preservation

Session Information

Date: Monday, June 13, 2016

Session Name: Poster Session C: Ischemia Reperfusion Injury and Organ Preservation

Session Time: 6:00pm-7:00pm

 Presentation Time: 6:00pm-7:00pm

Location: Halls C&D

Related Abstracts
  • Replacing Cold Storage with Normothermic Ex Vivo Kidney Perfusion Improves Function of Grafts Retrieved After Circulatory Death (DCD).
  • Normothermic Ex Vivo Liver Perfusion (NEVLP) Using Steen Solution as Preservation Technique for Liver Transplantation-First Clinical Results.

Introduction: Normothermic ex vivo liver perfusion (NEVLP) improves graft preservation by avoiding cold ischemic injury. We investigated if protective effects of NEVLP can be further improved by adding anti-inflammatory mediators to the perfusion solution.

Methods: Livers retrieved under heart beating conditions were perfused for 4 hours. Following preservation period, pig LT was performed. In the study group (n=5) anti-inflammatory strategies (alprostadil, n-acetylcysteine, CO and sevoflurane) were applied during subnormothermic temperature (33[deg]C). This was compared to a control group were livers (n=5) were perfused at 37[ordm]C without anti-inflammatory agents, similar to the setup in current European clinical trials. During 3-day follow-up, markers of reperfusioninjury, bile duct injury and liver function were examined.

Results: AST levels during perfusion were significantly lower in the study vs. control group at 1hr (52±6vs.162±86; p=0.016), 2hr (43±5vs.191±111; p=0.008) and 3hr (24±16vs.218±121; p=0.009). After transplantation, although there was no statistical difference between groups, the study group had lower AST peak levels (1400±653U/L vs. 2097±1071U/L; p=0.25). While alkaline phosphatase levels were similar between both groups, bilirubin levels were significantly lower in the study group at day 1 (3.6±1.5[micro]mol/l vs. 6.60±1.5[micro]mol/l; p=0.027) and 3 (2±1.1[micro]mol/l vs. 9.7±7.6[micro]mol/l; p=0.019). A trend towards decreased Hyaluronic Acid, as a marker of improved endothelial cell function, was observed at 1, 3 and 5hs after reperfusion in the study group vs control group. Only one early death occurred in each group (80% Survival).

Conclusion: Addition of anti-inflammatory strategies further improves normothermic perfused preservation.

CITATION INFORMATION: Goldaracena N, Juan E, Moritz K, Spetzler V, Barbas A, Grant D, Selzner M. Adding Anti-Inflammatory Agents During Normothermic Ex-Vivo Liver Perfusion Improves the Preservation of Pig Liver Grafts Before Transplantation. Am J Transplant. 2016;16 (suppl 3).

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To cite this abstract in AMA style:

Goldaracena N, Juan E, Moritz K, Spetzler V, Barbas A, Grant D, Selzner M. Adding Anti-Inflammatory Agents During Normothermic Ex-Vivo Liver Perfusion Improves the Preservation of Pig Liver Grafts Before Transplantation. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/adding-anti-inflammatory-agents-during-normothermic-ex-vivo-liver-perfusion-improves-the-preservation-of-pig-liver-grafts-before-transplantation/. Accessed March 4, 2021.

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