Is Ex Vivo Liver Perfusion a Safe Alternative to Cold Static Storage for the Preservation of Standard Criteria Grafts?
Multi Organ Transplant Program, Toronto General Hospital, Toronto, ON, Canada.
Meeting: 2015 American Transplant Congress
Abstract number: B297
Keywords: Liver preservation, Pig
Session Information
Session Name: Poster Session B: Vascularized Composite Tissue Allografts and Xenotransplantation
Session Type: Poster Session
Date: Sunday, May 3, 2015
Session Time: 5:30pm-6:30pm
Presentation Time: 5:30pm-6:30pm
Location: Exhibit Hall E
Objective: Subnormothermic ex vivo liver perfusion (SNEVLP) has recently attracted great interest in the field of organ preservation for marginal grafts. However, data is lacking regarding its safety as preservation method for good quality liver grafts with minimal injury. Therefore, our objective was to compare the outcome of SNEVLP vs. Cold storage (CS) using a model of heart beating donor pig liver transplantation.
Methods: Livers retrieved under heart beating conditions were either CS (n=8) for 6hr or preserved with a sequence of 3hr CS plus 3hr SNEVLP (33 °C) (n=8). After preservation, grafts were transplanted into recipient pigs. Within 4-day follow-up, markers of reperfusion and bile duct injury, as well as liver function were examined. Histology samples were taken at the end of survival.
Result: Mean AST levels during SNEVLP remained stable and within normal range (47±18U/L). As marker of reperfusion injury, 2-day AST levels were significantly lower (p=0.037) in the SNEVLP (317±188U/L) vs. CS (948±741U/L) group. Similar, peak levels of alkaline phosphatase were significantly lower in the SNEVLP vs CS group (SNEVLP: 150±19 vs. CS: 204±33 U/L; p=0.003). Peak bilirubin levels within 48hs after transplantation were lower in the perfused group without reaching statistical significance (SNEVLP: 2±1 vs. CS: 8±12 ¯o;mol/L; p=0.34). No difference was observed in post transplant INR levels between both groups (p=0.47). As a marker of improved endothelial cell function, Hyaluronic Acid levels at 3 (SNEVLP: 1226±545 vs. CS: 3974±1342 ng/ml; p=0.002) and 5 hs (SNEVLP: 1172±598 vs. CS: 5540±2755 ng/ml; p=0.006) after reperfusion were significantly lower in the SNEVLP group. Histology revealed minimal necrosis at the end of follow-up in both groups. Animal survival was considered permanent 4 days after transplantation. Four-day survival was not different between both groups (SNEVLP 75% vs. CS: 62%; p=0.61).
Conclusion: SNEVLP treatment as novel preservation method provides a superior endothelial cell protection, decreases hepatocyte and bile duct injury when compared to standard cold storage preservation. SNEVLP is safe and improves preservation even in low risk liver grafts.
To cite this abstract in AMA style:
Goldaracena N, Spetzler V, Kaths M, Echeverri J, Selzner M. Is Ex Vivo Liver Perfusion a Safe Alternative to Cold Static Storage for the Preservation of Standard Criteria Grafts? [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/is-ex-vivo-liver-perfusion-a-safe-alternative-to-cold-static-storage-for-the-preservation-of-standard-criteria-grafts/. Accessed May 16, 2025.« Back to 2015 American Transplant Congress