Normothermic Ex-Situ Liver Perfusion Parameters of Liver Viability in a Porcine Model of Liver Transplantation with Marginal Grafts

I. Linares-Cervantes¹, J. Echeverri¹, S. Cleland¹, M. Kaths¹, R. Rosales¹, T. Goto¹, D. Kollmann¹, M. Hamar¹, P. Urbanellis¹, L. Mazilescu¹, S. Ganesh¹, O. Adeyi¹, P. Yip¹, B. Bojko², P. Gorynzka², K. Gorynski², D. Grant¹, N. Selzner¹, M. Wasowicz¹, M. Selzner¹

¹Toronto General Hospital, Toronto, ON, Canada, ²University of Nicolaus Copernicus, Torun, Poland

Meeting: 2019 American Transplant Congress

Abstract number: B78

Keywords: Bile duct, Graft function, Machine preservation, Survival

Session Information

Session Name: Poster Session B: Biomarkers, Immune Monitoring and Outcomes

Session Type: Poster Session

Date: Sunday, June 2, 2019

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

Presentation Time: 6:00pm-7:00pm

Location: Hall C & D

*Purpose: Evaluate parameters of liver viability during normothermic ex-situ liver perfusion (NEsLP) prior to transplantation.

*Methods: In this study, we investigated prior assessed parameters and new variables to evaluate liver viability during NEsLP in a transplantation model. In addition, Rocuronium metabolism was assessed during NEsLP and after transplantation. We investigated groups with mild [heart beating donors(HBD)], moderate [donation after circulatory death donors with 30(DCD30´) and 70 minutes(DCD70´) of warm ischemia] and severe ischemic injury [donation after circulatory death donors with 120 minutes (DCD120´)of warm ischemia]. Parameters of hepatocellular and cholangiocyte function and injury were assessed during NEsLP and after transplantation.

*Results: The HBD, DCD30´ and DCD70´-groups had 100% survival. In contrast, 70% developed primary non-function (PNF) and died in the DCD120´-group. Hepatocellular function during NEsLP showed low lactate (≤1.1mmol/L) in all the groups except the DCD120´-group (>2mmol/L) at 4hr of perfusion (p=0.04). The fold-urea increase was significantly lower in the DCD120´-group (≤1.4) compared to the other groups (≥1.65) (p=0.01). As for cholangiocyte function, bile/perfusate glucose-ratio was significantly lower (<0.6) in all the groups but the DCD120´-group (≥0.9) after 3hr of perfusion (<0.01). Bile/perfusate Na+ ratio was significantly higher (≥1.2) after 3hr of perfusion in all the groups except for the DCD120´-group (≤1) (p<0.01). Three hours after transplantation, the DCD120´-group had a significantly higher INR (>5) compared to the rest of the groups (≤1.9) (p=0.02). Rocuronium levels were higher at all the time-points in the animals that developed PNF during NEsLP and after transplantation.

*Conclusions: This study demonstrates that parameters of hepatocellular and cholangiocyte function during NEsLP correlate with the degree of ischemic injury and post-transplant function.

To cite this abstract in AMA style:

Linares-Cervantes I, Echeverri J, Cleland S, Kaths M, Rosales R, Goto T, Kollmann D, Hamar M, Urbanellis P, Mazilescu L, Ganesh S, Adeyi O, Yip P, Bojko B, Gorynzka P, Gorynski K, Grant D, Selzner N, Wasowicz M, Selzner M. Normothermic Ex-Situ Liver Perfusion Parameters of Liver Viability in a Porcine Model of Liver Transplantation with Marginal Grafts [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/normothermic-ex-situ-liver-perfusion-parameters-of-liver-viability-in-a-porcine-model-of-liver-transplantation-with-marginal-grafts/. Accessed May 11, 2025.

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