Porcine Isolated Liver Perfusion for the Study of Ischemia Reperfusion Injury: A Systematic Review

[en] Background Understanding ischemia reperfusion injury (IRI) is essential to further improve outcomes after liver transplantation (LT). Porcine isolated liver perfusion (ILP) is increasingly used to reproduce LT-associated IRI in a strictly controlled environment. However, whether ILP is a reliable substitute of LT was never validated. Methods We systematically reviewed the current experimental setups for ILP and parameters of interest reflecting IRI. Results Isolated liver perfusion was never compared with transplantation in animals. Considerable variability exists between setups, and comparative data are unavailable. Experience so far suggests that centrifugal pump(s) with continuous flow are preferred to reduce the risk of embolism. Hepatic outflow can be established by cannulation of the inferior vena cava or freely drained in an open bath. Whole blood at approximately 38°C, hematocrit of 20% or greater, and the presence of leukocytes to trigger inflammation is considered the optimal perfusate. A number of parameters related to the 4 liver compartments (hepatocyte, cholangiocyte, endothelium, immune cells) are available; however, their significance and relation to clinical outcomes is not well described. Conclusions Porcine ILP provides a reproducible model to study early IRI events. As all models, it has its limitations. A standardization of the setup would allow comparison of data and progress in the field. © 2018 Wolters Kluwer Health, Inc. All rights reserved.

Disciplines :

Surgery

Author, co-author :

Maione, Francesca ^✱; Liver Transplantation Center and General Surgery 2U, AOU Città della Salute e della Scienza di Torino, University of Torino, Italy

Gilbo, NICHOLAS ^✱; Université de Liège - ULiège > Département des sciences cliniques > Pathologie chirurgicale abdominale et endocrinienne ; Centre Hospitalier Universitaire de Liège - CHU > > Service de chirurgie abdo, sénologique, endocrine et de transplantation

Lazzaro, Silvia; Abdominal Transplant Surgery, Department of Microbiology and Immunology, KU Leuven, University Hospitals, Leuven, Belgium

Friend, Peter; Nuffield Department of Surgery, University of Oxford, Oxford, United Kingdom

Camussi, Giovanni; Molecular Biotechnology Center, Department of Medical Sciences, University of Turin, Italy

Romagnoli, Renato; Liver Transplantation Center and General Surgery 2U, AOU Città della Salute e della Scienza di Torino, University of Torino, Italy

Pirenne, Jacques; Abdominal Transplant Surgery, Department of Microbiology and Immunology, KU Leuven, University Hospitals, Leuven, Belgium

Jochmans, Ina; Abdominal Transplant Surgery, Department of Microbiology and Immunology, KU Leuven, University Hospitals, Leuven, Belgium

Monbaliu, Diethard; Abdominal Transplant Surgery, Department of Microbiology and Immunology, KU Leuven, University Hospitals, Leuven, Belgium

^✱ These authors have contributed equally to this work.

Language :

English

Title :

Porcine Isolated Liver Perfusion for the Study of Ischemia Reperfusion Injury: A Systematic Review

Publication date :

2018

Journal title :

Transplantation

ISSN :

0041-1337

eISSN :

1534-6080

Publisher :

Lippincott Williams and Wilkins

Volume :

102

Issue :

Pages :

1039 - 1049

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 25 January 2024

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