ATC Abstracts

American Transplant Congress abstracts

  • Home
  • Meetings Archive
    • 2022 American Transplant Congress
    • 2021 American Transplant Congress
    • 2020 American Transplant Congress
    • 2019 American Transplant Congress
    • 2018 American Transplant Congress
    • 2017 American Transplant Congress
    • 2016 American Transplant Congress
    • 2015 American Transplant Congress
    • 2013 American Transplant Congress
  • Keyword Index
  • Resources
    • 2021 Resources
    • 2016 Resources
      • 2016 Welcome Letter
      • ATC 2016 Program Planning Committees
      • ASTS Council 2015-2016
      • AST Board of Directors 2015-2016
    • 2015 Resources
      • 2015 Welcome Letter
      • ATC 2015 Program Planning Committees
      • ASTS Council 2014-2015
      • AST Board of Directors 2014-2015
      • 2015 Conference Schedule
  • Search

Normothermic Ex Vivo Perfusion of Marginal Liver Grafts Rapidly Stimulates Release of Graft-Derived Exosomes and Markedly Decreases the Inflammatory Pathways Induced at Early Times after Transplant Reperfusion

K. E. Brown1, K. S. Keslar1, D. Margeta1, Q. Liu2, A. Simioni2, L. Del Angel Diaz2, W. M. Baldwin1, R. L. Fairchild1, C. Quintini2

1Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 2Transplant Center, Cleveland Clinic, Cleveland, OH

Meeting: 2020 American Transplant Congress

Abstract number: D-214

Keywords: Ischemia, Liver

Session Information

Session Name: Poster Session D: Non-Organ Specific: Organ Preservation/Ischemia Reperfusion Injury

Session Type: Poster Session

Date: Saturday, May 30, 2020

Session Time: 3:15pm-4:00pm

 Presentation Time: 3:30pm-4:00pm

Location: Virtual

*Purpose: Normothermic ex vivo machine perfusion of liver grafts (EVLP) is emerging as a superior preservation technology to cold storage. Normothermic EVLP transforms a metabolically dormant, continuously injured organ into a functioning one and improves the function and outcome of marginal liver transplants. Mechanisms underlying the improved restoration of livers subjected to EVLP prior to transplant are under study. We tested the hypothesis that subjecting livers to EVLP would decrease their innate immune activation and ability to active donor-reactive responses following reperfusion.

*Methods: Since the donor-reactive response is largely induced by graft production and release of exosomes, we tested graft production of exosomes in the perfusate during the 4-6 hours of EVLP. Perfusate was obtained at the beginning and every two hours after initiation of EVLP for 10 livers conditioned for transplant. Exosomes were isolated from the perfusates by a four centrifugation cycle and quantitated by ZetaView.

*Results: For each of the 10 livers, graft exosomes were released as a bolus within 2 hours of EVLP initiation and then were no longer detectable in the perfusate. The exosomes were able to stimulate the proliferation of CFSE-labelled CD4 and CD8 T cells when added to peripheral blood mononuclear cell cultures for 3 days and then analyzed by flow cytometry for CFSE dilution as an indicator of T cell proliferation. Biopsies were procured from livers subjected to EVLP and control unconditioned livers just prior to placement into the recipient abdomen (implantation biopsy) and another at 1-2 hours after revascularization, just prior to abdomen closure (reperfusion biopsy). Biopsy RNA was isolated and subjected to Nano String analysis using the Human Pan Cancer CodeSet. Reperfusion biopsies (n = 5) of liver transplants subjected to EVLP had marked down regulation of gene expression associated with pathways involved in complement activation and complement regulation, inflammasome activation, and chemokine receptor signaling.

*Conclusions: Overall, these results indicate that normothermic EVLP prior to transplant reduces the inflammatory response to reperfusion during transplant and suggests that the graft allogenicity may also be decreased through release of immunogenic exosomes during the perfusion.

  • Tweet
  • Email
  • Print

To cite this abstract in AMA style:

Brown KE, Keslar KS, Margeta D, Liu Q, Simioni A, Diaz LDelAngel, Baldwin WM, Fairchild RL, Quintini C. Normothermic Ex Vivo Perfusion of Marginal Liver Grafts Rapidly Stimulates Release of Graft-Derived Exosomes and Markedly Decreases the Inflammatory Pathways Induced at Early Times after Transplant Reperfusion [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/normothermic-ex-vivo-perfusion-of-marginal-liver-grafts-rapidly-stimulates-release-of-graft-derived-exosomes-and-markedly-decreases-the-inflammatory-pathways-induced-at-early-times-after-transplant-re/. Accessed May 11, 2025.

« Back to 2020 American Transplant Congress

Visit Our Partner Sites

American Transplant Congress (ATC)

Visit the official site for the American Transplant Congress »

American Journal of Transplantation

The official publication for the American Society of Transplantation (AST) and the American Society of Transplant Surgeons (ASTS) »

American Society of Transplantation (AST)

An organization of more than 3000 professionals dedicated to advancing the field of transplantation. »

American Society of Transplant Surgeons (ASTS)

The society represents approximately 1,800 professionals dedicated to excellence in transplantation surgery. »

Copyright © 2013-2025 by American Society of Transplantation and the American Society of Transplant Surgeons. All rights reserved.

Privacy Policy | Terms of Use | Cookie Preferences