Aim. Transplantation using livers donation after circulatory death (DCD) is associated with worse outcomes compared to using donation after brain death (DBD). Considerable research resources are being invested into methods in improving DCD outcomes, including normothermic machine perfusion (NMP). However, current models of DCD inducing circulatory death by exsanguination or potassium chloride injection are not clinically permitted. We therefore present a clinically relevant model. Methods. Landrace pigs were anaesthetised and intubated. Life support withdrawal occurred by means of cessation of ventilation. Death was confirmed by disappearance of pulse pressure or electrical silence on ECG, followed by a 5 min stand-off before cold preservation flush and explantation of the liver. No heparin was administered before death. Livers were subsequently prepared for NMP. Results. Mean time to asystole was 9.27 min. Mean warm ischaemic time was 20.25 min. Livers were maintained on NMP for 4 hours demonstrating favourable biochemical profiles and bile production (Figure 1). Conclusion. Our preliminary results indicate that the livers remain viable using a clinically relevant DCD model. Further research is required to identify the optimum time of NMP and potentially optimise liver preservation with improved oxygenation and perfusate parameters.

Figure 1. machine perfused liver.

CITATION INFORMATION: Cao Y, Chew H, Fernandez K, Gao L, Villanueva J, Hicks M, Macdonald P, Dhital K, Pleass H. Normothermic Perfusion of Livers Donated After Circulatory Death: A New Clinically Relevant Experimental Model. Am J Transplant. 2016;16 (suppl 3).

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