Donor liver quality after hypovolemic shock and venous systemic oxygen persufflation in an experimental animal model
Abstract Background The ever growing demand for liver transplantation inevitably necessitates an expansion of the donor pool. Utilization of “shock organs” is considered suboptimal to date while the associated outcome has hardly been investigated. Materials and methods Male Wistar rats underwent a p...
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| Format: | Article |
| Language: | English |
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BMC
2018-10-01
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| Series: | European Journal of Medical Research |
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| Online Access: | http://link.springer.com/article/10.1186/s40001-018-0346-5 |
| _version_ | 1818302061881589760 |
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| author | Azin Jafari Hanno Matthaei Vittorio Branchi Edwin Bölke Rene H. Tolba Jörg C. Kalff Steffen Manekeller |
| author_facet | Azin Jafari Hanno Matthaei Vittorio Branchi Edwin Bölke Rene H. Tolba Jörg C. Kalff Steffen Manekeller |
| author_sort | Azin Jafari |
| collection | DOAJ |
| description | Abstract Background The ever growing demand for liver transplantation inevitably necessitates an expansion of the donor pool. Utilization of “shock organs” is considered suboptimal to date while the associated outcome has hardly been investigated. Materials and methods Male Wistar rats underwent a period of 30 min of hypovolemic shock. After 24 h livers were explanted and prior to reperfusion underwent either 18 h of cold storage (CS; N = 6) or 17 h of CS followed by 60 min venous systemic oxygen persufflation (VSOP; N = 6). The outcome of “shock organs (SHBD)” was compared to heart-beating donor (HBD; N = 12) as positive control and non-heart-beating donor (NHBD; N = 12) as negative control animal groups. Liver function was assessed by measuring enzyme release (AST, ALT, LDH), bile production, portal vein pressure and hepatic oxygen uptake during reperfusion. For reperfusion, the isolated perfused rat liver system was used. Results Liver function was severely limited in NHBD group compared to HBD organs after 18 h of CS (e.g., AST; HBD: 32.25 ± 7.25 U/l vs. NHBD: 790 ± 414.56 U/l; p < 0.005). VSOP improved liver function of NHBD organs significantly (AST; NHBD + VSOP: 333.6 ± 149.1 U/l; p < 0.005). SHBD organs showed a comparable outcome to HBD and clearly better results than NHBD organs after 18 h of CS (AST; SHBD: 76.4 ± 21.9 U/l). After 17 h of CS accompanied by 60 min VSOP, no improvement concerning liver function and integrity of SHBD organs was observed while the results were severely deteriorated by VSOP resulting in higher enzyme release (AST; SHBD + VSOP: 213 ± 61 U/l, p < 0.001), higher portal vein pressure (SHBD: 10.8 ± 1.92 mm Hg vs. SHBD + VSOP: 21.6 ± 8.8 mm Hg; p < 0.05) and lower hepatic oxygen uptake (SHBD: 321.75 ± 3.87 ml/glw/min vs. SHBD + VSOP: 395.8 ± 46.64 ml/glw/min, p < 0.05) at 24 h. Conclusions Our data suggest that the potential of “shock organs” within liver transplantation may be underestimated. If our findings are reproducable in humans, SHBD grafts should be considered as a valuable source for expanding the thus far limited donor pool. |
| first_indexed | 2024-12-13T05:32:55Z |
| format | Article |
| id | doaj.art-a646c81819f34e299ceb77b33f439878 |
| institution | Directory Open Access Journal |
| issn | 2047-783X |
| language | English |
| last_indexed | 2024-12-13T05:32:55Z |
| publishDate | 2018-10-01 |
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| series | European Journal of Medical Research |
| spelling | doaj.art-a646c81819f34e299ceb77b33f4398782022-12-21T23:58:01ZengBMCEuropean Journal of Medical Research2047-783X2018-10-0123111110.1186/s40001-018-0346-5Donor liver quality after hypovolemic shock and venous systemic oxygen persufflation in an experimental animal modelAzin Jafari0Hanno Matthaei1Vittorio Branchi2Edwin Bölke3Rene H. Tolba4Jörg C. Kalff5Steffen Manekeller6Department of Surgery, Faculty of Medicine, Rheinische Friedrich-Wilhelms-UniversitätDepartment of Surgery, Faculty of Medicine, Rheinische Friedrich-Wilhelms-UniversitätDepartment of Surgery, Faculty of Medicine, Rheinische Friedrich-Wilhelms-UniversitätDepartment of Radiotherapy and Radiation Oncology, Faculty of Medicine, Heinrich-Heine-UniversitätInstitute for Laboratory Animal Science and Experimental Surgery, University Hospital Rheinisch-Westfälische Technische Hochschule AachenDepartment of Surgery, Faculty of Medicine, Rheinische Friedrich-Wilhelms-UniversitätDepartment of Surgery, Faculty of Medicine, Rheinische Friedrich-Wilhelms-UniversitätAbstract Background The ever growing demand for liver transplantation inevitably necessitates an expansion of the donor pool. Utilization of “shock organs” is considered suboptimal to date while the associated outcome has hardly been investigated. Materials and methods Male Wistar rats underwent a period of 30 min of hypovolemic shock. After 24 h livers were explanted and prior to reperfusion underwent either 18 h of cold storage (CS; N = 6) or 17 h of CS followed by 60 min venous systemic oxygen persufflation (VSOP; N = 6). The outcome of “shock organs (SHBD)” was compared to heart-beating donor (HBD; N = 12) as positive control and non-heart-beating donor (NHBD; N = 12) as negative control animal groups. Liver function was assessed by measuring enzyme release (AST, ALT, LDH), bile production, portal vein pressure and hepatic oxygen uptake during reperfusion. For reperfusion, the isolated perfused rat liver system was used. Results Liver function was severely limited in NHBD group compared to HBD organs after 18 h of CS (e.g., AST; HBD: 32.25 ± 7.25 U/l vs. NHBD: 790 ± 414.56 U/l; p < 0.005). VSOP improved liver function of NHBD organs significantly (AST; NHBD + VSOP: 333.6 ± 149.1 U/l; p < 0.005). SHBD organs showed a comparable outcome to HBD and clearly better results than NHBD organs after 18 h of CS (AST; SHBD: 76.4 ± 21.9 U/l). After 17 h of CS accompanied by 60 min VSOP, no improvement concerning liver function and integrity of SHBD organs was observed while the results were severely deteriorated by VSOP resulting in higher enzyme release (AST; SHBD + VSOP: 213 ± 61 U/l, p < 0.001), higher portal vein pressure (SHBD: 10.8 ± 1.92 mm Hg vs. SHBD + VSOP: 21.6 ± 8.8 mm Hg; p < 0.05) and lower hepatic oxygen uptake (SHBD: 321.75 ± 3.87 ml/glw/min vs. SHBD + VSOP: 395.8 ± 46.64 ml/glw/min, p < 0.05) at 24 h. Conclusions Our data suggest that the potential of “shock organs” within liver transplantation may be underestimated. If our findings are reproducable in humans, SHBD grafts should be considered as a valuable source for expanding the thus far limited donor pool.http://link.springer.com/article/10.1186/s40001-018-0346-5Liver transplantationHypovolemic shockShock organsVSOP |
| spellingShingle | Azin Jafari Hanno Matthaei Vittorio Branchi Edwin Bölke Rene H. Tolba Jörg C. Kalff Steffen Manekeller Donor liver quality after hypovolemic shock and venous systemic oxygen persufflation in an experimental animal model European Journal of Medical Research Liver transplantation Hypovolemic shock Shock organs VSOP |
| title | Donor liver quality after hypovolemic shock and venous systemic oxygen persufflation in an experimental animal model |
| title_full | Donor liver quality after hypovolemic shock and venous systemic oxygen persufflation in an experimental animal model |
| title_fullStr | Donor liver quality after hypovolemic shock and venous systemic oxygen persufflation in an experimental animal model |
| title_full_unstemmed | Donor liver quality after hypovolemic shock and venous systemic oxygen persufflation in an experimental animal model |
| title_short | Donor liver quality after hypovolemic shock and venous systemic oxygen persufflation in an experimental animal model |
| title_sort | donor liver quality after hypovolemic shock and venous systemic oxygen persufflation in an experimental animal model |
| topic | Liver transplantation Hypovolemic shock Shock organs VSOP |
| url | http://link.springer.com/article/10.1186/s40001-018-0346-5 |
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