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Won N, Castillo-Prado J, Tan X, Ford J, Heath D, Mazilescu LI, Selzner M, Rogers IM. Correction: Won et al. Ex Vivo Perfusion Using a Mathematical Modeled, Controlled Gas Exchange Self-Contained Bioreactor Can Maintain a Mouse Kidney for Seven Days. Cells 2022, 11, 1822. Cells 2024; 13:714. [PMID: 38667337 PMCID: PMC11048796 DOI: 10.3390/cells13080714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 04/08/2024] [Indexed: 04/29/2024] Open
Abstract
In the original publication [...].
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Affiliation(s)
- Natalie Won
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada; (N.W.); (J.C.-P.); (X.T.)
- School of Biomedical Engineering, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Jorge Castillo-Prado
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada; (N.W.); (J.C.-P.); (X.T.)
- Department of Physiology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Xinzhu Tan
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada; (N.W.); (J.C.-P.); (X.T.)
- Department of Physiology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - John Ford
- Department of Chemistry, University of Toronto, Toronto, ON M5S 3H6, Canada; (J.F.); (D.H.)
| | - David Heath
- Department of Chemistry, University of Toronto, Toronto, ON M5S 3H6, Canada; (J.F.); (D.H.)
| | - Laura Ioana Mazilescu
- Department of General, Visceral and Transplantation Surgery, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany;
- Soham & Shaila Ajmera Family Transplant Centre, University Health Network, Toronto, ON M5G 2C4, Canada;
| | - Markus Selzner
- Soham & Shaila Ajmera Family Transplant Centre, University Health Network, Toronto, ON M5G 2C4, Canada;
- Toronto General Hospital Research Institute, Toronto, ON M5G 2C4, Canada
| | - Ian M. Rogers
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada; (N.W.); (J.C.-P.); (X.T.)
- Department of Physiology, University of Toronto, Toronto, ON M5S 1A8, Canada
- Soham & Shaila Ajmera Family Transplant Centre, University Health Network, Toronto, ON M5G 2C4, Canada;
- Toronto General Hospital Research Institute, Toronto, ON M5G 2C4, Canada
- Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON M5G 1E2, Canada
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Mazilescu LI, Goto T, John R, Rosales R, Ganesh S, Yu F, Noguchi Y, Kawamura M, Dezard V, Gao F, Urbanellis P, Parmentier C, Konvalinka A, Bagli DJ, Reichman TW, Robinson LA, Selzner M. Combining Oxygenated Cold Perfusion With Normothermic Ex Vivo Perfusion Improves the Outcome of Donation After Circulatory Death Porcine Kidney Transplantation. Transplantation 2024; 108:184-191. [PMID: 37505906 DOI: 10.1097/tp.0000000000004734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2023]
Abstract
BACKGROUND Ex vivo machine perfusion is a novel preservation technique for storing and assessing marginal kidney grafts. All ex vivo perfusion techniques have advantages and shortcomings. The current study analyzed whether a combination of oxygenated hypothermic machine perfusion (oxHMP) followed by a short period of normothermic ex vivo kidney perfusion (NEVKP) could combine the advantages of both techniques. METHODS Porcine kidneys were exposed to 30 min of warm ischemia followed by perfusion. Kidneys underwent either 16-h NEVKP or 16-h oxHMP. The third group was exposed to 16-h oxHMP followed by 3-h NEVKP (oxHMP + NEVKP group). After contralateral nephrectomy, grafts were autotransplanted and animals were followed up for 8 d. RESULTS All animals survived the follow-up period. Grafts preserved by continuous NEVKP showed improved function with lower peak serum creatinine and more rapid recovery compared with the other 2 groups. Urine neutrophil gelatinase-associated lipocalin, a marker of kidney injury, was found to be significantly lowered on postoperative day 3 in the oxHMP + NEVKP group compared with the other 2 groups. CONCLUSIONS A short period of NEVKP after oxHMP provides comparable short-term outcomes to prolonged NEVKP and is superior to oxHMP alone. A combination of oxHMP with end-ischemic NEVKP could be an attractive, practical strategy to combine the advantages of both preservation techniques.
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Affiliation(s)
- Laura Ioana Mazilescu
- Ajmera Transplant Centre, Toronto General Hospital, Toronto, ON, Canada
- Division of Nephrology, The Hospital for Sick Children, Toronto, ON, Canada
- Department of General, Visceral, and Transplantation Surgery, University Hospital Essen, Essen, Germany
- Division of General Surgery, University Health Network, Toronto, ON, Canada
| | - Toru Goto
- Ajmera Transplant Centre, Toronto General Hospital, Toronto, ON, Canada
- Division of General Surgery, University Health Network, Toronto, ON, Canada
| | - Rohan John
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
- Department of Pathology, University Health Network, Toronto, ON, Canada
| | - Roizar Rosales
- Division of General Surgery, University Health Network, Toronto, ON, Canada
| | - Sujani Ganesh
- Ajmera Transplant Centre, Toronto General Hospital, Toronto, ON, Canada
| | - Frank Yu
- Ajmera Transplant Centre, Toronto General Hospital, Toronto, ON, Canada
| | - Yuki Noguchi
- Ajmera Transplant Centre, Toronto General Hospital, Toronto, ON, Canada
- Division of General Surgery, University Health Network, Toronto, ON, Canada
| | - Masataka Kawamura
- Ajmera Transplant Centre, Toronto General Hospital, Toronto, ON, Canada
- Division of Nephrology, The Hospital for Sick Children, Toronto, ON, Canada
- Division of General Surgery, University Health Network, Toronto, ON, Canada
| | - Victoria Dezard
- Ajmera Transplant Centre, Toronto General Hospital, Toronto, ON, Canada
| | - Fei Gao
- Ajmera Transplant Centre, Toronto General Hospital, Toronto, ON, Canada
| | - Peter Urbanellis
- Ajmera Transplant Centre, Toronto General Hospital, Toronto, ON, Canada
- Division of General Surgery, University Health Network, Toronto, ON, Canada
| | - Catherine Parmentier
- Ajmera Transplant Centre, Toronto General Hospital, Toronto, ON, Canada
- Division of General Surgery, University Health Network, Toronto, ON, Canada
| | - Ana Konvalinka
- Ajmera Transplant Centre, Toronto General Hospital, Toronto, ON, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
- Division of Nephrology, Department of Medicine, University Health Network, University of Toronto, Toronto, ON, Canada
- Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Darius J Bagli
- Department of Urology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Trevor W Reichman
- Ajmera Transplant Centre, Toronto General Hospital, Toronto, ON, Canada
- Division of General Surgery, University Health Network, Toronto, ON, Canada
| | - Lisa A Robinson
- Division of Nephrology, The Hospital for Sick Children, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Program in Cell Biology, The Hospital for Sick Children Research Institute, Toronto, ON, Canada
| | - Markus Selzner
- Ajmera Transplant Centre, Toronto General Hospital, Toronto, ON, Canada
- Division of General Surgery, University Health Network, Toronto, ON, Canada
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Fidan D, Mero G, Mazilescu LI, Heuer T, Kaiser GM. Mixed reality combined with ALPPS for colorectal liver metastases, a case report. Int J Surg Case Rep 2023; 109:108624. [PMID: 37562278 PMCID: PMC10432778 DOI: 10.1016/j.ijscr.2023.108624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 08/01/2023] [Accepted: 08/01/2023] [Indexed: 08/12/2023] Open
Abstract
INTRODUCTION Improvement of treatments for patients suffering from colorectal carcinoma and extended liver metastases has increased the overall survival and enables more patients to undergo surgical therapy. If the future liver remnant (FLR) is expected to be low, Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy (ALPPS) is a potential treatment with high feasibility and an increase in overall survival. The evolving mixed reality technology could support hepatobiliary surgery. This case report demonstrates for the first time the combination of mixed reality technology and ALPPS procedure for a patient with low expected FLR. PRESENTATION OF CASE A 49-year-old patient is presented with adenocarcinoma of the caecum with bilateral liver metastasis. After colon resection, a palliative chemotherapy was administered with good response and partial remission, so curative liver resection was intended. Based on the low expected FLR, calculated from the 3D-model of the liver, we decided to perform an in-situ split resection supported by mixed reality intraoperatively. The total operation time was 6 + 2 h. During both steps no blood transfusion was required and no major complication occurred. The patient was discharged 15 days after the second step. Final pathology revealed multiple predominantly necrotic metastases of the pre-existing colon carcinoma (ypM1, R0). DISCUSSION After the first step of ALPPS, an increase of the FLR up to 57 % was achieved, so the second step was performed on postoperative day (POD)11. The 3D-model and the intraoperative use of mixed reality supported our decision making and intraoperative navigation. This technique could be implemented on a larger scale to support complex liver resections. CONCLUSION The combination of mixed reality with ALPPS resulted in a good surgical outcome and should be considered as a potential alternative for liver resections.
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Affiliation(s)
- Darick Fidan
- Department of General Surgery, St. Bernhard Hospital, Kamp-Lintfort, Germany.
| | - Genadi Mero
- Department of General Surgery, St. Bernhard Hospital, Kamp-Lintfort, Germany
| | - Laura Ioana Mazilescu
- Department of General Surgery, St. Bernhard Hospital, Kamp-Lintfort, Germany; Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Essen, Germany.
| | - Theodor Heuer
- Department of General Surgery, St. Bernhard Hospital, Kamp-Lintfort, Germany.
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Mazilescu LI, Bernheim I, Treckmann J, Radunz S. Donor, Recipient and Surgeon Sex and Sex-Concordance and their Impact on Liver Transplant Outcome. J Pers Med 2023; 13:jpm13020281. [PMID: 36836516 PMCID: PMC9959865 DOI: 10.3390/jpm13020281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/25/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
(1) Background: Patient sex is associated with differential outcome of many procedures although the exact mechanisms remain unknown. Especially in transplant surgery, surgeon-patient sex-concordance is rarely present for female patients and outcome may be negatively affected. (2) Methods: In this single-center retrospective cohort study, recipient, donor, and surgeon sex were evaluated and short- and long-term outcome was analyzed with regards to sex and sex-concordance of patients, donors, and surgeons. (3) Results: We included 425 recipients in our study; 50.1% of organ donors, 32.7% of recipients, and 13.9% of surgeons were female. Recipient-donor sex concordance was present in 82.7% of female recipients and in 65.7% of male recipients (p = 0.0002). Recipient-surgeon sex concordance was present in 11.5% of female recipients and in 85.0% of male recipients (p < 0.0001). Five-year patient survival was comparable between female and male recipients (70.0% vs. 73.3%, p = 0.3978). Five-year patient survival of female recipients treated by female surgeons was improved without reaching significance (81.3% vs. 68.4%, p = 0.3621). (4) Conclusions: Female recipients and female surgeons are underrepresented in liver transplant surgery. Societal factors influencing outcome of female patients suffering from end-stage organ failure need to be further examined and acted upon to possibly improve the outcome of female liver transplant recipients.
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Abstract
Liver steatosis is emerging as a major cause of chronic liver disease worldwide, mainly due to the increasing rate of obesity, type 2 diabetes, and metabolic syndrome. Because of the increased incidence of liver steatosis, many organs are currently declined for transplantation despite high demand and waiting list mortality. Defatting strategies have recently emerged as a means of rapidly reducing liver steatosis to expand the pool of available organs. This review summarises advances in defatting strategies in experimental and human models of liver steatosis over the last 20 years.
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Key Words
- GDNF, glial cell-line derived neurotrophic factor
- HFD, high-fat diet
- HIEC, hepatic endothelial cells
- HOPE, hypothermic machine perfusion
- LDs, lipid droplets
- Macrosteatosis
- NAFL, non-alcoholic fatty liver
- NAFLD, non-alcoholic fatty liver disease
- NASH, non-alcoholic steatohepatitis
- NEsLP, normothermic ex situ machine perfusion
- PHHs, primary human hepatocytes
- PPAR, peroxisome proliferator-activated receptor
- PXR, pregnane X receptor
- SCS, static cold storage
- SRS, steatosis reduction supplements
- TG, triglyceride
- ischemia-reperfusion injury
- liver transplantation
- machine perfusion
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Affiliation(s)
- Laura Ioana Mazilescu
- Ajmera Transplant Program, Toronto General Hospital, Ontario, Canada
- Division of Nephrology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of General, Visceral, and Transplantation Surgery, University Hospital Essen, Essen, Germany
| | - Markus Selzner
- Ajmera Transplant Program, Toronto General Hospital, Ontario, Canada
| | - Nazia Selzner
- Ajmera Transplant Program, Toronto General Hospital, Ontario, Canada
- Corresponding author. Address: Multi-Organ Transplant Program, Toronto General Hospital, 585 University Avenue, 11 PMB-178 Toronto, ON, Canada M5G 2N2.
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