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One-Pump versus Two-Pump Normothermic Ex Vivo Perfusion Machines in Discarded Human Livers

A. Hassan, Q. Liu, D. Pezzati, A. Nassar, B. Soliman, M. Blum, P. Grady, G. Iuppa, T. Uso, J. Fung, K. Abu-Elmagd, C. Quintini.

Transplant Surgery, Cleveland Clinic, Cleveland.

Meeting: 2018 American Transplant Congress

Abstract number: 201

Keywords: Liver, Liver preservation, Liver transplantation, Preservation

Session Information

Session Name: Concurrent Session: Ischemia Reperfusion Injury: Time to Change the Paradigm?

Session Type: Concurrent Session

Date: Monday, June 4, 2018

Session Time: 2:30pm-4:00pm

 Presentation Time: 3:18pm-3:30pm

Location: Room 6B

Introduction:Physiologic flows and pressures need to be provided by the ex vivo liver perfusion device. We hypothesized that the 1-pump designed machines would provide the same hemodynamic output provided by the 2-pump designed perfusion machines.

Methods: 11 human livers that were declined for transplantation were ex vivoperfused for 8 h at 37[deg]C with an oxygenated solution based on red blood cells and plasma, using either two pump design (n=6) or one pump design (n=5) to provide a pressure controlled continuous perfusion to the hepatic artery and portal vein.Both groups were tested during the perfusion for Hemodynamic feasibility and safety including markers of hemolysis.

Results: During perfusion, the hepatic artery and portal vein hemodynamic parameters were within physiologic values in both groups with no significant difference between the two groups. We observed no significant drop in the hemoglobin or hematocrit in the two groups during the entire perfusion. Similarly no significant increase in the potassium levels was reported in the two groups to suggest hemolysis.

1 Hour 4 Hour 8 Hour
1-pump 2-pump p 1-pump 2-pump p 1-pump 2-pump p
HA flow(ml/min) 519±149 449±103 0.3 529±138 495±92 0.6 550±200 511±83 0.6
PV flows(ml/min) 1203±284 1375±256 0.3 1229±254 1513±312 0.1 1093±183 1550±444 0.06
HA pressure(mmHg) 79±7 81±7 0.6 80±8 95±10 0.1 85±10 88±10 0.6
PV pressure(mmHg) 7.6±4 7±2 0.7 7.2±3 7.2±2 0.9 8.3±4 6.8±2 0.4
Potassium(mmol/l) 7.1±3 6.3±3 0.6 6.3±1 5.7±3 0.7 6.1±5 5.4±3 0.7
Hematocrit(%) 17.6±4 14.3±2 0.1 16.8±5 12.9±1.6 0.1 13.9±1.5 12.2±2 0.1
Hemoglobin(g/dl) 5.8±1 4.97±0.6 0.1 5.6±2 4.67±0.5 0.2 4.6±0.3 4.47±0.6 0.6

Conclusion:1-pump design provides the same hemodynamic output provided by the 2-pump design for discarded human liver perfusion. This did not occur at the expenses of hemolysis or other unexpected complications.

CITATION INFORMATION: Hassan A., Liu Q., Pezzati D., Nassar A., Soliman B., Blum M., Grady P., Iuppa G., Uso T., Fung J., Abu-Elmagd K., Quintini C. One-Pump versus Two-Pump Normothermic Ex Vivo Perfusion Machines in Discarded Human Livers Am J Transplant. 2017;17 (suppl 3).

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To cite this abstract in AMA style:

Hassan A, Liu Q, Pezzati D, Nassar A, Soliman B, Blum M, Grady P, Iuppa G, Uso T, Fung J, Abu-Elmagd K, Quintini C. One-Pump versus Two-Pump Normothermic Ex Vivo Perfusion Machines in Discarded Human Livers [abstract]. https://atcmeetingabstracts.com/abstract/one-pump-versus-two-pump-normothermic-ex-vivo-perfusion-machines-in-discarded-human-livers/. Accessed May 16, 2025.

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