From the Department of Liver Transplantation & Hepatobiliary-Pancreatic Surgery (Al-Sebayel, El-Sheikh, Al Abbad, Al Nemry, Al-Jammali, Al-Zeer, Alsebayel, Al-Bahli); and from the Department of Comparative Medicine (Al-Mohanna), King Faisal Specialist Hospital & Research Center, Riyadh, Kingdom of Saudi Arabia.
Saudi Med J. 2021 Dec;42(12):1289-1295. doi: 10.15537/smj.2021.42.12.20210054.
To describe a novel animal model for ex-vivo liver perfusion.
This study was carried out at King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia, between September 2016 and January 2019. We assembled a perfusion circuit operated by a continuous pressure-driven arterial pump with continuous portal and arterial pressure and volume measurements. We used normothermic oxygenated perfusate. The livers used were retrieved from the sheep.
Ex-vivo continuous perfusion of the liver was achieved for up to 9 hours with stable pressure and volume in both hepatic artery and portal vein. In 4 experiments the arterial pressure was kept in a range of 48-52 mmHg with a mean of 51.75±4.31 resulting in arterial volume at steady state of 223.5±48.25 ml/minute (95% confidence level). At steady state the mean portal pressure was 16.25±1.45 mmHg with a mean volume of 854±313.75 ml/minute (95% confidence level). Bile production was observed during the perfusion period. Hemodynamic parameters were similar to the physiological parameters observed in normothermic perfusion model of the porcine liver.
A normothermic oxygenated ex-vivo perfusion circuit was successfully constructed using the sheep liver. A sustainable functional circuit with physiological hemodynamic parameters was achieved. Further study on sheep model seems to be feasible.
描述一种新型的离体肝脏灌注动物模型。
本研究于 2016 年 9 月至 2019 年 1 月在沙特阿拉伯利雅得的法赫德国王专科医院和研究中心进行。我们组装了一个由连续压力驱动动脉泵操作的灌注回路，可进行连续的门脉和动脉压力及容量测量。我们使用常温充氧的灌流液。所使用的肝脏取自绵羊。
离体肝脏连续灌注时间长达 9 小时，肝动脉和门静脉的压力和容量均保持稳定。在 4 个实验中，动脉压保持在 48-52mmHg 之间，平均为 51.75±4.31mmHg，导致动脉稳态容量为 223.5±48.25ml/min（95%置信区间）。在稳态时，门静脉平均压力为 16.25±1.45mmHg，平均容量为 854±313.75ml/min（95%置信区间）。在灌注期间观察到胆汁生成。血流动力学参数与猪肝脏常温灌注模型中观察到的生理参数相似。
成功地使用绵羊肝脏构建了常温充氧的离体灌注回路。实现了具有生理血流动力学参数的可持续功能回路。在绵羊模型上进一步研究似乎是可行的。
