Single vs dual vessel porcine extracorporeal liver perfusion

N. Mora, L. Kaptanoglu, Z. Zhang, Marek Niekrasz, S. Black, K. Ver Steeg, R. Wade, V. Siddall, W. Pao, W. Walsh, D. Ivancic, D. Kaufman, M. Abecassis, F. Stuart, A. Blei, J. Leventhal, J. Fryer

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background. The use of porcine extracorporeal liver perfusion (PECLP) to provide temporary hepatic support for patients in fulminant hepatic failure has been limited by the fact that individual perfusions can be sustained for only a few hours. Inadequate liver function and/or hemodynamic instability are the major contributing factors for early interruption of PECLP. Recent reports suggest that the choice of single (portal vein only) vs dual (portal vein and hepatic artery) vessel perfusion may influence the duration of perfusion. We hypothesize that PECLP with single vessel perfusion (SVP) is associated with worse liver function and greater hemodynamic instability than PECLP with dual vessel perfusion (DVP). Materials and methods. To eliminate the potentially confounding influences of liver failure and xenograft rejection, liver isografts procured from White-Landrace pig donors were perfused by either SVP or DVP via an extracorporeal circuit established with normal White-Landrace pig recipients. The function of perfused livers was evaluated by measuring production of bile and Factors V and VIII, clearance of ammonia and lactate, and extraction of O2 at baseline and at 0, 1, 3, 6, 12, and 24 h after initiation of PECLP. The impact of PECLP on recipient hemodynamic status was assessed by monitoring BP, heart rate, urine output, O2 saturation, etc. Among other parameters evaluated were serum albumin and total protein and hepatic release of IL-1β and nitric oxide to assess their possible contributions to hemodynamic instability. Results. DVP and SVP livers cleared ammonia and lactate similarly. Both approaches were associated with progressive hypoalbuminemia and hypoproteinemia. DVP livers produced more bile and Factor V and were associated with less recipient hypotension and IL-1β and NO release than SVP livers. Conclusions. Livers with DVP function better than livers with SVP. The duration of PECLP can be limited by recipient hypotension, although this complication is less severe with DVP than with SVP.

Original languageEnglish (US)
Pages (from-to)228-235
Number of pages8
JournalJournal of Surgical Research
Volume103
Issue number2
DOIs
StatePublished - Jan 1 2002

Fingerprint

Swine
Perfusion
Liver
Hemodynamics
Factor V
Portal Vein
Interleukin-1
Ammonia
Bile
Hypotension
Lactic Acid
Isografts
Hypoproteinemia
Hypoalbuminemia
Acute Liver Failure
Hepatic Artery
Liver Failure
Factor VIII
Heterografts
Serum Albumin

Keywords

  • Extracorporeal liver perfusion
  • Porcine

ASJC Scopus subject areas

  • Surgery

Cite this

Mora, N., Kaptanoglu, L., Zhang, Z., Niekrasz, M., Black, S., Ver Steeg, K., ... Fryer, J. (2002). Single vs dual vessel porcine extracorporeal liver perfusion. Journal of Surgical Research, 103(2), 228-235. https://doi.org/10.1006/jsre.2002.6366

Single vs dual vessel porcine extracorporeal liver perfusion. / Mora, N.; Kaptanoglu, L.; Zhang, Z.; Niekrasz, Marek; Black, S.; Ver Steeg, K.; Wade, R.; Siddall, V.; Pao, W.; Walsh, W.; Ivancic, D.; Kaufman, D.; Abecassis, M.; Stuart, F.; Blei, A.; Leventhal, J.; Fryer, J.

In: Journal of Surgical Research, Vol. 103, No. 2, 01.01.2002, p. 228-235.

Research output: Contribution to journalArticle

Mora, N, Kaptanoglu, L, Zhang, Z, Niekrasz, M, Black, S, Ver Steeg, K, Wade, R, Siddall, V, Pao, W, Walsh, W, Ivancic, D, Kaufman, D, Abecassis, M, Stuart, F, Blei, A, Leventhal, J & Fryer, J 2002, 'Single vs dual vessel porcine extracorporeal liver perfusion', Journal of Surgical Research, vol. 103, no. 2, pp. 228-235. https://doi.org/10.1006/jsre.2002.6366
Mora N, Kaptanoglu L, Zhang Z, Niekrasz M, Black S, Ver Steeg K et al. Single vs dual vessel porcine extracorporeal liver perfusion. Journal of Surgical Research. 2002 Jan 1;103(2):228-235. https://doi.org/10.1006/jsre.2002.6366
Mora, N. ; Kaptanoglu, L. ; Zhang, Z. ; Niekrasz, Marek ; Black, S. ; Ver Steeg, K. ; Wade, R. ; Siddall, V. ; Pao, W. ; Walsh, W. ; Ivancic, D. ; Kaufman, D. ; Abecassis, M. ; Stuart, F. ; Blei, A. ; Leventhal, J. ; Fryer, J. / Single vs dual vessel porcine extracorporeal liver perfusion. In: Journal of Surgical Research. 2002 ; Vol. 103, No. 2. pp. 228-235.
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abstract = "Background. The use of porcine extracorporeal liver perfusion (PECLP) to provide temporary hepatic support for patients in fulminant hepatic failure has been limited by the fact that individual perfusions can be sustained for only a few hours. Inadequate liver function and/or hemodynamic instability are the major contributing factors for early interruption of PECLP. Recent reports suggest that the choice of single (portal vein only) vs dual (portal vein and hepatic artery) vessel perfusion may influence the duration of perfusion. We hypothesize that PECLP with single vessel perfusion (SVP) is associated with worse liver function and greater hemodynamic instability than PECLP with dual vessel perfusion (DVP). Materials and methods. To eliminate the potentially confounding influences of liver failure and xenograft rejection, liver isografts procured from White-Landrace pig donors were perfused by either SVP or DVP via an extracorporeal circuit established with normal White-Landrace pig recipients. The function of perfused livers was evaluated by measuring production of bile and Factors V and VIII, clearance of ammonia and lactate, and extraction of O2 at baseline and at 0, 1, 3, 6, 12, and 24 h after initiation of PECLP. The impact of PECLP on recipient hemodynamic status was assessed by monitoring BP, heart rate, urine output, O2 saturation, etc. Among other parameters evaluated were serum albumin and total protein and hepatic release of IL-1β and nitric oxide to assess their possible contributions to hemodynamic instability. Results. DVP and SVP livers cleared ammonia and lactate similarly. Both approaches were associated with progressive hypoalbuminemia and hypoproteinemia. DVP livers produced more bile and Factor V and were associated with less recipient hypotension and IL-1β and NO release than SVP livers. Conclusions. Livers with DVP function better than livers with SVP. The duration of PECLP can be limited by recipient hypotension, although this complication is less severe with DVP than with SVP.",
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AU - Mora, N.

AU - Kaptanoglu, L.

AU - Zhang, Z.

AU - Niekrasz, Marek

AU - Black, S.

AU - Ver Steeg, K.

AU - Wade, R.

AU - Siddall, V.

AU - Pao, W.

AU - Walsh, W.

AU - Ivancic, D.

AU - Kaufman, D.

AU - Abecassis, M.

AU - Stuart, F.

AU - Blei, A.

AU - Leventhal, J.

AU - Fryer, J.

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N2 - Background. The use of porcine extracorporeal liver perfusion (PECLP) to provide temporary hepatic support for patients in fulminant hepatic failure has been limited by the fact that individual perfusions can be sustained for only a few hours. Inadequate liver function and/or hemodynamic instability are the major contributing factors for early interruption of PECLP. Recent reports suggest that the choice of single (portal vein only) vs dual (portal vein and hepatic artery) vessel perfusion may influence the duration of perfusion. We hypothesize that PECLP with single vessel perfusion (SVP) is associated with worse liver function and greater hemodynamic instability than PECLP with dual vessel perfusion (DVP). Materials and methods. To eliminate the potentially confounding influences of liver failure and xenograft rejection, liver isografts procured from White-Landrace pig donors were perfused by either SVP or DVP via an extracorporeal circuit established with normal White-Landrace pig recipients. The function of perfused livers was evaluated by measuring production of bile and Factors V and VIII, clearance of ammonia and lactate, and extraction of O2 at baseline and at 0, 1, 3, 6, 12, and 24 h after initiation of PECLP. The impact of PECLP on recipient hemodynamic status was assessed by monitoring BP, heart rate, urine output, O2 saturation, etc. Among other parameters evaluated were serum albumin and total protein and hepatic release of IL-1β and nitric oxide to assess their possible contributions to hemodynamic instability. Results. DVP and SVP livers cleared ammonia and lactate similarly. Both approaches were associated with progressive hypoalbuminemia and hypoproteinemia. DVP livers produced more bile and Factor V and were associated with less recipient hypotension and IL-1β and NO release than SVP livers. Conclusions. Livers with DVP function better than livers with SVP. The duration of PECLP can be limited by recipient hypotension, although this complication is less severe with DVP than with SVP.

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