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Tamaki Y, Hatayama N, Fujii Y, Naito M. A compact machine perfusion device for whole blood perfusion in isolated rat liver. J Artif Organs 2024:10.1007/s10047-024-01474-8. [PMID: 39363050 DOI: 10.1007/s10047-024-01474-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Accepted: 09/19/2024] [Indexed: 10/05/2024]
Abstract
We established a compact machine perfusion system for whole blood perfusion of rat liver by making use of oxygenation filters as an artificial lung. Livers removed from rats were divided into Krebs-Henseleit (control), 50% blood (hemoglobin: 7 g/dL), and whole blood (hemoglobin: 14 g/dL) groups, then perfused (total perfusate volume: 25 ml) with a small oxygenation filter at 37 °C for 120 min. Blood or perfusate was collected over time, and blood gas and blood cell were measured. In addition, bile volume and portal venous pressure measurements were taken. In all groups, the partial pressure of oxygen was controlled to approximately 400 mmHg. Flow rates were maintained at approximately about 20-30 ml/min according to liver size. Portal venous pressure was normal in the 50% blood and whole blood groups, while lower than the reference value in the Krebs-Henseleit group. Twice as much bile was produced in the 50% blood and whole blood groups relative with the Krebs-Henseleit group. We observed no differences in hemoglobin and red blood cell levels. Lactate levels were normal in the 50% blood and whole blood groups, but were elevated in the Krebs-Henseleit group. Our compact perfusion system using oxygenation filters was able to maintain rat liver function by perfusing a small amount of extracorporeal blood. This system is simple and stable, and may contribute to the future development of machine perfusion systems.
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Affiliation(s)
- Yuki Tamaki
- Department of Anatomy, Aichi Medical University, Nagakute, Aichi, 480-1195, Japan.
| | - Naoyuki Hatayama
- Department of Anatomy, Aichi Medical University, Nagakute, Aichi, 480-1195, Japan
| | - Yutaka Fujii
- Department of Clinical Engineering and Medical Technology, Niigata University of Health and Welfare, Niigata, Japan
| | - Munekazu Naito
- Department of Anatomy, Aichi Medical University, Nagakute, Aichi, 480-1195, Japan.
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Yang Z, Wu L, Hou P, Zhang X, Jiang P, Li M. Prognosis Analysis of Rat Liver Transplantation Under Direct Vision of Single Operator. Transplant Proc 2024; 56:1904-1912. [PMID: 39242317 DOI: 10.1016/j.transproceed.2024.08.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Accepted: 08/24/2024] [Indexed: 09/09/2024]
Abstract
OBJECTIVE This study aims to investigate the impact of surgical experimental variables on the prognosis of orthotopic liver transplantation (OLT) in rats, with the goal of enhancing the efficacy of modeling techniques. METHODS Using Kamada's "two-cuff method" of rat orthotopic liver transplantation, 76 pairs of SD-Wistar rats were performed orthotopic liver transplantation from March to September 2023. Thirteen experimental factors during the perioperative period and the survival time of recipient rats were collected and recorded. To explore the surgical factors affecting the prognosis of rat liver transplantation and summarize the surgical techniques. RESULTS The success rate of orthotopic liver transplantation in SD-Wistar rats was 68.4%, with 24 recipients surviving within 3-7 days and 28 recipients surviving more than 1 week. Donor liver perfusion, recipient blood loss, recipient liver blood expulsion, anhepatic phase, suprahepatic inferior vena cava anastomosis time and anesthesia recovery time are related to the survival of recipient rats after liver transplantation. Donor liver perfusion, eliminating blood in recipient liver and intraoperative blood loss of recipient are surgical factors affecting the prognosis of liver transplantation in rats. The survival time of recipient rats with liver perfusion through abdominal aorta, eliminating blood in recipient liver was relatively prolonged after operation. CONCLUSION Under the condition of reasonable control of the anhepatic phase, the perfusion method of the donor liver, whether to eliminate blood in recipient liver, and intraoperative blood loss of recipient are important surgical factors affecting the prognosis of liver transplantation in rats.
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Affiliation(s)
- Zhiqi Yang
- Third Clinical Medical College of Ningxia Medical University, Yin Chuan, Ningxia Hui Autonomous Region, People's Republic of China; Hepatobiliary Surgery Department of Ningxia Hui Autonomous Region People's Hospital, Yin Chuan, Ningxia Hui Autonomous Region, People's Republic of China.
| | - Lang Wu
- Hepatobiliary Surgery Department of Ningxia Hui Autonomous Region People's Hospital, Yin Chuan, Ningxia Hui Autonomous Region, People's Republic of China.
| | - Peibo Hou
- Third Clinical Medical College of Ningxia Medical University, Yin Chuan, Ningxia Hui Autonomous Region, People's Republic of China.
| | - Xining Zhang
- Hepatobiliary Surgery Department of Ningxia Hui Autonomous Region People's Hospital, Yin Chuan, Ningxia Hui Autonomous Region, People's Republic of China.
| | - Peng Jiang
- Third Clinical Medical College of Ningxia Medical University, Yin Chuan, Ningxia Hui Autonomous Region, People's Republic of China.
| | - Minghao Li
- Third Clinical Medical College of Ningxia Medical University, Yin Chuan, Ningxia Hui Autonomous Region, People's Republic of China; Hepatobiliary Surgery Department of Ningxia Hui Autonomous Region People's Hospital, Yin Chuan, Ningxia Hui Autonomous Region, People's Republic of China.
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Berkane Y, Lellouch AG, Goudot G, Shamlou A, Filz von Reiterdank I, Goutard M, Tawa P, Girard P, Bertheuil N, Uygun BE, Randolph MA, Duisit J, Cetrulo CL, Uygun K. Towards Optimizing Sub-Normothermic Machine Perfusion in Fasciocutaneous Flaps: A Large Animal Study. Bioengineering (Basel) 2023; 10:1415. [PMID: 38136006 PMCID: PMC10740951 DOI: 10.3390/bioengineering10121415] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/23/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023] Open
Abstract
Machine perfusion has developed rapidly since its first use in solid organ transplantation. Likewise, reconstructive surgery has kept pace, and ex vivo perfusion appears as a new trend in vascularized composite allotransplants preservation. In autologous reconstruction, fasciocutaneous flaps are now the gold standard due to their low morbidity (muscle sparing) and favorable functional and cosmetic results. However, failures still occasionally arise due to difficulties encountered with the vessels during free flap transfer. The development of machine perfusion procedures would make it possible to temporarily substitute or even avoid microsurgical anastomoses in certain complex cases. We performed oxygenated acellular sub-normothermic perfusions of fasciocutaneous flaps for 24 and 48 h in a porcine model and compared continuous and intermittent perfusion regimens. The monitored metrics included vascular resistance, edema, arteriovenous oxygen gas differentials, and metabolic parameters. A final histological assessment was performed. Porcine flaps which underwent successful oxygenated perfusion showed minimal or no signs of cell necrosis at the end of the perfusion. Intermittent perfusion allowed overall better results to be obtained at 24 h and extended perfusion duration. This work provides a strong foundation for further research and could lead to new and reliable reconstructive techniques.
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Affiliation(s)
- Yanis Berkane
- Division of Plastic and Reconstructive Surgery, Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA 02114, USA; (A.G.L.); (I.F.v.R.); (M.G.); (P.T.); (M.A.R.)
- Harvard Medical School, Boston, MA 02115, USA;
- Department of Plastic, Reconstructive, and Aesthetic Surgery, CHU de Rennes, Université de Rennes, 35000 Rennes, France; (P.G.); (N.B.); (J.D.)
- Shriners Children’s Boston, Boston, MA 02114, USA
- SITI Laboratory, UMR1236, INSERM, Université de Rennes, 35000 Rennes, France
| | - Alexandre G. Lellouch
- Division of Plastic and Reconstructive Surgery, Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA 02114, USA; (A.G.L.); (I.F.v.R.); (M.G.); (P.T.); (M.A.R.)
- Harvard Medical School, Boston, MA 02115, USA;
- Shriners Children’s Boston, Boston, MA 02114, USA
- Innovative Therapies in Haemostasis, INSERM UMR-S 1140, University of Paris, 75006 Paris, France
| | - Guillaume Goudot
- Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02115, USA;
- INSERM U970 PARCC, Université Paris Cité, 75000 Paris, France
| | - Austin Shamlou
- Division of Plastic and Reconstructive Surgery, Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA 02114, USA; (A.G.L.); (I.F.v.R.); (M.G.); (P.T.); (M.A.R.)
- Harvard Medical School, Boston, MA 02115, USA;
- Shriners Children’s Boston, Boston, MA 02114, USA
| | - Irina Filz von Reiterdank
- Division of Plastic and Reconstructive Surgery, Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA 02114, USA; (A.G.L.); (I.F.v.R.); (M.G.); (P.T.); (M.A.R.)
- Harvard Medical School, Boston, MA 02115, USA;
- Shriners Children’s Boston, Boston, MA 02114, USA
- Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA 02115, USA
- University Medical Center Utrecht, 3584 Utrecht, The Netherlands
| | - Marion Goutard
- Division of Plastic and Reconstructive Surgery, Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA 02114, USA; (A.G.L.); (I.F.v.R.); (M.G.); (P.T.); (M.A.R.)
- Harvard Medical School, Boston, MA 02115, USA;
- Shriners Children’s Boston, Boston, MA 02114, USA
- SITI Laboratory, UMR1236, INSERM, Université de Rennes, 35000 Rennes, France
| | - Pierre Tawa
- Division of Plastic and Reconstructive Surgery, Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA 02114, USA; (A.G.L.); (I.F.v.R.); (M.G.); (P.T.); (M.A.R.)
- Harvard Medical School, Boston, MA 02115, USA;
- Shriners Children’s Boston, Boston, MA 02114, USA
| | - Paul Girard
- Department of Plastic, Reconstructive, and Aesthetic Surgery, CHU de Rennes, Université de Rennes, 35000 Rennes, France; (P.G.); (N.B.); (J.D.)
| | - Nicolas Bertheuil
- Department of Plastic, Reconstructive, and Aesthetic Surgery, CHU de Rennes, Université de Rennes, 35000 Rennes, France; (P.G.); (N.B.); (J.D.)
- SITI Laboratory, UMR1236, INSERM, Université de Rennes, 35000 Rennes, France
| | - Basak E. Uygun
- Harvard Medical School, Boston, MA 02115, USA;
- Shriners Children’s Boston, Boston, MA 02114, USA
- Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA 02115, USA
| | - Mark A. Randolph
- Division of Plastic and Reconstructive Surgery, Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA 02114, USA; (A.G.L.); (I.F.v.R.); (M.G.); (P.T.); (M.A.R.)
- Harvard Medical School, Boston, MA 02115, USA;
- Shriners Children’s Boston, Boston, MA 02114, USA
| | - Jérôme Duisit
- Department of Plastic, Reconstructive, and Aesthetic Surgery, CHU de Rennes, Université de Rennes, 35000 Rennes, France; (P.G.); (N.B.); (J.D.)
- Iris South Hospitals, 1040 Brussels, Belgium
| | - Curtis L. Cetrulo
- Division of Plastic and Reconstructive Surgery, Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA 02114, USA; (A.G.L.); (I.F.v.R.); (M.G.); (P.T.); (M.A.R.)
- Harvard Medical School, Boston, MA 02115, USA;
- Shriners Children’s Boston, Boston, MA 02114, USA
| | - Korkut Uygun
- Harvard Medical School, Boston, MA 02115, USA;
- Shriners Children’s Boston, Boston, MA 02114, USA
- Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA 02115, USA
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