Huang Viola, Karimian Negin, Detelich Danielle, Raigani Siavash, Geerts Sharon, Beijert Irene, Fontan Fermin M, Aburawi Mohamed M, Ozer Sinan, Banik Peony, Lin Florence, Karabacak Murat, Hafiz Ehab O A, Porte Robert J, Uygun Korkut, Markmann James F, Yeh Heidi
Division of Transplant Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
Center for Engineering in Medicine, Department of Surgery, Massachusetts General Hospital, Boston, MA 02114, USA.
J Clin Med. 2020 Jan 18;9(1):269. doi: 10.3390/jcm9010269.
Ex situ machine perfusion is a promising technology to help improve organ viability prior to transplantation. However, preclinical studies using discarded human livers to evaluate therapeutic interventions and optimize perfusion conditions are limited by significant graft heterogeneity. In order to improve the efficacy and reproducibility of future studies, a split-liver perfusion model was developed to allow simultaneous perfusion of left and right lobes, allowing one lobe to serve as a control for the other. Eleven discarded livers were surgically split, and both lobes perfused simultaneously on separate perfusion devices for 3 h at subnormothermic temperatures. Lobar perfusion parameters were also compared with whole livers undergoing perfusion. Similar to whole-liver perfusions, each lobe in the split-liver model exhibited a progressive decrease in arterial resistance and lactate levels throughout perfusion, which were not significantly different between right and left lobes. Split liver lobes also demonstrated comparable energy charge ratios. Ex situ split-liver perfusion is a novel experimental model that allows each graft to act as its own control. This model is particularly well suited for preclinical studies by avoiding the need for large numbers of enrolled livers necessary due to the heterogenous nature of discarded human liver research.
体外机器灌注是一种很有前景的技术，有助于在移植前提高器官的存活率。然而，利用废弃人体肝脏评估治疗干预措施并优化灌注条件的临床前研究受到显著的移植物异质性的限制。为了提高未来研究的有效性和可重复性，开发了一种劈离式肝脏灌注模型，以便同时对左右肝叶进行灌注，使一个肝叶作为另一个肝叶的对照。对11个废弃肝脏进行手术劈离，两个肝叶在不同的灌注装置上同时进行亚低温灌注3小时。还将肝叶灌注参数与进行灌注的全肝进行了比较。与全肝灌注相似，劈离式肝脏模型中的每个肝叶在整个灌注过程中动脉阻力和乳酸水平均呈逐渐下降趋势，左右肝叶之间无显著差异。劈离的肝叶也显示出相当的能荷比。体外劈离式肝脏灌注是一种新型实验模型，可使每个移植物作为自身的对照。该模型特别适合临床前研究，因为它避免了因废弃人体肝脏研究的异质性而需要大量纳入肝脏的情况。
