Transport and Preservation of Liver in a Revolutionary Medical Device

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Abstract

Background and Aims

The injury of the graft during the period in which the donor organ is transported until it is implanted in the recipient negatively affect the quality of liver grafts from extended criteria donors and the post-operative outcomes after transplant. Herein, we evaluated whether a new medical device based on the combination of ultrasounds and hypothermic conditions increases the viability of liver grafts during cold ischemia before being implanted in the recipient, in comparison to what could be obtained with known devices

Methods

Pig livers grafts were perfused with preservation solution and kept in the cooler with or without ultrasound for 8h. Liver and perfusate samples were collected to assess liver damage induced by ischemia. Transaminases and lactate dehydrogenase were measured in the perfusate and caspase 3 activity in liver. MDA levels were determined in liver an oxidative stress index, and hepatic ATP levels were determined as an energy metabolism preservation index.

Results

The protection of liver grafts (confirmed by the reduction in transaminases, lactate dehydrogenase, caspase 3 and MDA as well as ATP preservation) conferred by UW solution under cold conditions (2-6°C) is higher than that obtained with Celsior or Ringer solution. Our results indicated a synergistic effect when both cold conditions (2-6°C) and ultrasound treatment (at low frequency and intensity) are combined because the protection obtained when both treatments are combined is much better than the sum of protections obtained when both treatments are applied separately. The protection conferred by ultrasound was independently of the preservation solution used.

Conclusions

We provide a revolutionary method and medical device for transporting and storing liver grafts under better conditions than those currently available. All this allows reducing the harmful effects of cold ischemia and increasing viability of grafts before they are implanted in the recipient.

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