Assessment of liver function during extracorporeal membrane oxygenation in the non-heart beating donor swine

Transplantation Proceedings
A RojasJ D Arenas

Abstract

Although the use of non-heart beating donors (NHBD) could bridge the widening gap between organ demand and supply, its application to liver transplantation is limited due to warm ischemia (WI), biliary tree injury, and inadequate organ assessment. Warm blood reperfusion using extracorporeal membrane oxygenation (ECMO) can be a suitable option to reduce WI in organs from NHBD, allowing one to determine hepatic flow characteristics and bile production and facilitating assessment of organ viability. This work evaluates the use of warm blood veno-arterial ECMO reperfusion in NHBD swine. Systemic and hepatic hemodynamics, bile, urine, and mixed venous blood were measured. After baseline data collection, 10 kU heparin was given intravenously followed by 1 g KCl to elicit cardiac arrest (CA). ECMO was started after 30 or 60 minutes of CA and kept running for 120 minutes. One-way repeated measures analysis of variance (ANOVA) with Tukey test analysis was used within a group. Two-way ANOVA was used between groups. ECMO can restore venous SO2 and pH in both groups; the values were close to baseline in the 30-minute CA group. Also, in this group, bile production was > 65% from baseline early during reperfusion and its value was lower in t...Continue Reading

References

Jan 27, 1995·Transplantation·A CasavillaT Starzl
Jan 22, 1998·The New England Journal of Medicine·Y W ChoD W Gjertson

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Citations

Jan 22, 2009·Transplantation·Herman TolboomMartin L Yarmush
Jun 10, 2009·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Junewai L ReomaRobert H Bartlett
Jun 18, 2010·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·A Rojas-PenaJ D Punch
Apr 29, 2014·Journal of Hepatology·Jay A Graham, James V Guarrera
Jul 25, 2014·Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research·Rezà F Saidi, Seyed Kamran Hejazi Kenari
Jul 26, 2011·Journal of Hepatology·Diethard MonbaliuDavid Talbot
Sep 23, 2009·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Nabeel R ObeidJeffrey D Punch
Jul 8, 2011·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Alvaro Rojas-PenaJeffrey D Punch
Dec 18, 2013·The International Journal of Artificial Organs·Bote G BruinsmaKorkut Uygun
Apr 9, 2015·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·David S DemosAlvaro Rojas-Peña

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