Defatting of Steatotic Liver Grafts by Normothermic Ex Vivo Liver Machine Perfusion with 2,4 Dinitrophenol

J. M. Gassner¹, J. Michelotto¹, S. Moosburner¹, F. Strobl¹, A. L. Birkenfeld², A. Kurzbach², G. Shulman³, X. Zhang³, M. Selzner⁴, Y. Noguchi⁴, J. Pratschke¹, I. M. Sauer¹, N. Raschzok¹

¹Department of Surgery, Experimental Surgery, Charité – Universitätsmedizin Berlin, Berlin, Germany, ²Division of Endocrinology, Diabetology and Nephrology, Department of Internal Medicine, Internal, University Hospital Tübingen, Tübingen, Germany, ³Departments of Internal Medicine and Cellular & Molecular Physiology, Yale Diabetes Research Center, Yale School of Medicine, New Haven, CT, ⁴Multi Organ Transplant Program, Ajmera Family Transplant Center, Toronto General Hospital, University of Toronto, Toronto, ON, Canada

Meeting: 2022 American Transplant Congress

Abstract number: 945

Keywords: Liver, Machine preservation

Topic: Basic Science » Basic Science » 15 - Machine Perfusion and Organ Rehabililtation - Basic

Session Information

Session Name: Machine Perfusion and Organ Rehabilitation - Basic

Session Type: Poster Abstract

Date: Sunday, June 5, 2022

Session Time: 7:00pm-8:00pm

Presentation Time: 7:00pm-8:00pm

Location: Hynes Halls C & D

*Purpose: The purpose of the study is to demonstrate that steatotic liver grafts can be defatted by normothermic ex vivo liver machine perfusion (NEVLP) with 2,4 Dinitrophenol (DNP) by uncoupling of the mitochondrial ATP production.

*Methods: Steatotic livers from Sprague Dawley rats generated by a 3-week high-fat diet and controls from lean rats were perfused for 3 and 6 hours using a rat NEVLP system with 0, 100, 200, 300, 400, and 500 µmol of DNP (n=6 per group). In addition, two severely steatotic, discarded human livers were treated over 12 hours with and without 200 µmol DNP by NEVLP. Perfusate and tissue samples were used for biochemical, molecular, and histological analyses.

*Results: DNP had a time- and dose-dependent effect on triglyceride content (p<0.0001) and Oil-red-O staining, with only minimal DNP accumulation in liver tissue. Perfusate lactate (34.5 vs. 8.3mg/dL; p=0.001) and tissue triglyceride levels (81.2 vs. 56.01mg/g; p=0.021) indicated optimal dose-response after 6 hours of perfusion with 200 µmol of DNP, with sustained bile production (622.5 vs. 488.8mg at 6h; p=0.93) and low transaminase secretion (127U/L vs. 127.5U/L ALT at 6h; p>0.999) compared to controls. Western blots showed increased levels of mitochondrial fission factor and a positive effect on posphorylated Akt kinase and caspase 9 levels. In contrast to the control, the human liver treated with DNP cleared lactate after 1 hour, maintained perfusate pH after 9 hours and produced bile after 11 hours of NEVLP.

*Conclusions: DNP has the potential of future clinical application for conditioning of severely steatotic liver grafts by NEVLP.

To cite this abstract in AMA style:

Gassner JM, Michelotto J, Moosburner S, Strobl F, Birkenfeld AL, Kurzbach A, Shulman G, Zhang X, Selzner M, Noguchi Y, Pratschke J, Sauer IM, Raschzok N. Defatting of Steatotic Liver Grafts by Normothermic Ex Vivo Liver Machine Perfusion with 2,4 Dinitrophenol [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/defatting-of-steatotic-liver-grafts-by-normothermic-ex-vivo-liver-machine-perfusion-with-24-dinitrophenol/. Accessed May 9, 2025.

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