A fitness index for transplantation of machine-perfused cadaveric rat livers
<p>Abstract</p> <p>Background</p> <p>The 110,000 patients currently on the transplant waiting list reflect the critical shortage of viable donor organs. However, a large pool of unused organs, from donors after cardiac death (DCD) that are disqualified because of extens...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2012-06-01
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| Series: | BMC Research Notes |
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| Online Access: | http://www.biomedcentral.com/1756-0500/5/325 |
| _version_ | 1818157858554904576 |
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| author | Perk Sinem Izamis Maria-Louisa Tolboom Herman Uygun Basak Yarmush Martin L Uygun Korkut |
| author_facet | Perk Sinem Izamis Maria-Louisa Tolboom Herman Uygun Basak Yarmush Martin L Uygun Korkut |
| author_sort | Perk Sinem |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>The 110,000 patients currently on the transplant waiting list reflect the critical shortage of viable donor organs. However, a large pool of unused organs, from donors after cardiac death (DCD) that are disqualified because of extensive ischemic injury, may prove transplantable after machine perfusion treatment, fundamentally impacting the availability of treatment for end-stage organ failure. Machine perfusion is an ex-vivo organ preservation and treatment procedure that has the capacity to quantitatively evaluate and resuscitate cadaveric organs for transplantation.</p> <p>Methods</p> <p>To diagnose whether an organ was fresh or ischemic, an initial assessment of liver quality was conducted via dynamic discriminant analysis. Subsequently, to determine whether the organs were sufficiently viable for successful implantation, fitness indices for transplantation were calculated based on squared prediction errors (SPE) for fresh and ischemic livers.</p> <p>Results</p> <p>With just three perfusate metabolites, glucose, urea and lactate, the developed MPLSDA model distinguished livers as fresh or ischemic with 90% specificity. The SPE analyses revealed that fresh livers with SPE<sub>F</sub> < 10.03 and WI livers with SPE<sub>WI</sub> < 3.92 yield successful transplantation with 95% specificity.</p> <p>Conclusions</p> <p>The statistical methods used here can discriminate between fresh and ischemic livers based on simple metabolic indicators measured during perfusion. The result is a predictive fitness index for transplantation of rat livers procured after cardiac death. The translational implications of this study are that any donor organ procured from controlled, but most especially from uncontrolled cardiac death donors, will be objectively assessed and its recovery monitored over time, minimizing the critical loss of otherwise viable organs.</p> |
| first_indexed | 2024-12-11T15:20:52Z |
| format | Article |
| id | doaj.art-6dfed277824a4e42a556ae67c1b2a823 |
| institution | Directory Open Access Journal |
| issn | 1756-0500 |
| language | English |
| last_indexed | 2024-12-11T15:20:52Z |
| publishDate | 2012-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Research Notes |
| spelling | doaj.art-6dfed277824a4e42a556ae67c1b2a8232022-12-22T01:00:22ZengBMCBMC Research Notes1756-05002012-06-015132510.1186/1756-0500-5-325A fitness index for transplantation of machine-perfused cadaveric rat liversPerk SinemIzamis Maria-LouisaTolboom HermanUygun BasakYarmush Martin LUygun Korkut<p>Abstract</p> <p>Background</p> <p>The 110,000 patients currently on the transplant waiting list reflect the critical shortage of viable donor organs. However, a large pool of unused organs, from donors after cardiac death (DCD) that are disqualified because of extensive ischemic injury, may prove transplantable after machine perfusion treatment, fundamentally impacting the availability of treatment for end-stage organ failure. Machine perfusion is an ex-vivo organ preservation and treatment procedure that has the capacity to quantitatively evaluate and resuscitate cadaveric organs for transplantation.</p> <p>Methods</p> <p>To diagnose whether an organ was fresh or ischemic, an initial assessment of liver quality was conducted via dynamic discriminant analysis. Subsequently, to determine whether the organs were sufficiently viable for successful implantation, fitness indices for transplantation were calculated based on squared prediction errors (SPE) for fresh and ischemic livers.</p> <p>Results</p> <p>With just three perfusate metabolites, glucose, urea and lactate, the developed MPLSDA model distinguished livers as fresh or ischemic with 90% specificity. The SPE analyses revealed that fresh livers with SPE<sub>F</sub> < 10.03 and WI livers with SPE<sub>WI</sub> < 3.92 yield successful transplantation with 95% specificity.</p> <p>Conclusions</p> <p>The statistical methods used here can discriminate between fresh and ischemic livers based on simple metabolic indicators measured during perfusion. The result is a predictive fitness index for transplantation of rat livers procured after cardiac death. The translational implications of this study are that any donor organ procured from controlled, but most especially from uncontrolled cardiac death donors, will be objectively assessed and its recovery monitored over time, minimizing the critical loss of otherwise viable organs.</p>http://www.biomedcentral.com/1756-0500/5/325Transplantation indexPrincipal component analysis (PCA)Partial least squares (PLS)Extracorporeal liver perfusionDonors after cardiac death |
| spellingShingle | Perk Sinem Izamis Maria-Louisa Tolboom Herman Uygun Basak Yarmush Martin L Uygun Korkut A fitness index for transplantation of machine-perfused cadaveric rat livers BMC Research Notes Transplantation index Principal component analysis (PCA) Partial least squares (PLS) Extracorporeal liver perfusion Donors after cardiac death |
| title | A fitness index for transplantation of machine-perfused cadaveric rat livers |
| title_full | A fitness index for transplantation of machine-perfused cadaveric rat livers |
| title_fullStr | A fitness index for transplantation of machine-perfused cadaveric rat livers |
| title_full_unstemmed | A fitness index for transplantation of machine-perfused cadaveric rat livers |
| title_short | A fitness index for transplantation of machine-perfused cadaveric rat livers |
| title_sort | fitness index for transplantation of machine perfused cadaveric rat livers |
| topic | Transplantation index Principal component analysis (PCA) Partial least squares (PLS) Extracorporeal liver perfusion Donors after cardiac death |
| url | http://www.biomedcentral.com/1756-0500/5/325 |
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