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Experimental Machine Liver Perfusion ex vivo: First Russian Case-Report

Affiliations

  • I.P. Pavlov First Saint-Petersburg Medical University, Saint Petersburg, Russian Federation
  • I.I. Janelidze Saint-Petersburg Research Institute of Emergency Care, Saint Petersburg, Russian Federation
  • Central Research Institute of Robotics and Technical Cybernetics, Saint Petersburg, Russian Federation

Abstract


Background/Objectives: The article describes preclinical trials of a new apparatus for normothermic machine perfusion of the donor liver that was designed and developed in the Central Research Institute of Robotics and Technical Cybernetics (Saint-Petersburg, Russia). Methods: An experimental study of a new apparatus for isolated perfusion of donor liver was performed on the isolated pig liver. Microcirculation parameters were controlled using computerized dopplerography ultrasound for blood flow studies MM-E-K. Findings: The device consists of the following components - two pumps for pumping fluids in two hydraulic circuits; container, wherein the sealed package is a liver transplant; pump control system; touch screen for setting input and output; uninterruptible power supply to provide mobile functions. Porcine liver was isolated, explanted and after 30 minutes of warm ischemia time it was placed into the apparatus from the pig after induced cardiac death. Liver was perfused with a perfusate of an original composition maintaining its viability. The developed apparatus maintained separate peristaltic blood flow in portal vein at 1.5 l/min and in common hepatic artery at 0.3 l/min, which corresponds to the physiological parameters. Perfusion using the developed apparatus for machine perfusion allowed restoring and preserving the functional state of the liver after 30 minutes of warm ischemia time, as evidenced by spontaneous recovery of the bile outflow, color and texture of the liver graft. Biochemical data values stabilize at physiological levels within 40 minutes after the start of perfusion. Applications/Improvements: The perfusion device is designed to restore and maintain the viability of the donor organ (liver) using extracorporeal flow normothermic perfusion of donor organs.

Keywords

Cold Ischemia Time, Donors after Sudden Irreversible Cardiac Arrest, Machine Isolated Perfusion of the Liver Graft, Organ Transplantation, The Primary Warm Ischemia.

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