Haemoadsorption cartridge connected to the machine perfusion for donation after circulatory death porcine liver marginal grafts  

作　　者：Irene Scalera Rossana Franzin Alessandra Stasi Antonino Castellaneta Enrico Fischetti Giulia Morelli Margherita Raele Emilio Panetta Andjela Kurevija William Pulga Mauro Atti Loreto Gesualdo 

机构地区：[1]Hepatobiliary and Liver Transplant Unit,University Hospital Policlinic of Bari,Bari 70124,Puglia,Italy [2]Division of Nephrology,Department of Dialysis and Transplant,University Hospital Policlinic of Bari,Bari 70124,Puglia,Italy [3]Gastroenterology and Digestive Endoscopy Unit,University Hospital Policlinic of Bari,Bari 70124,Puglia,Italy [4]Department of Aferetica,Aferetica Srl,Bologna 40138,Emilia-Romagna,Italy

出　　处：《World Journal of Transplantation》2025年第2期300-308,共9页世界移植杂志(英文)

摘　　要：BACKGROUND Marginal donation after circulatory death(DCD)liver grafts are carefully used to combat the constant shortage of donors.Clinically,the worst outcomes are mainly related to severe ischemia-reperfusion-injury and the dangerous effect of various inflammatory cytokines(CK).The machine perfusion(MP)is a promising device to rescue these grafts.AIM To analyze the role of MP connected to a sorbent cartridge(PerSorb®)and used for very damaged DCD pig livers.METHODS Seven grafts were procured from pigs from a slaughterhouse.Grafts were made very marginal with at least 60 minutes of donor warm ischemia time and 24 hours of static-cold ischemia time:(1)3 grafts were perfused in hypothermic MP with PerSorb(Sorb);(2)2 other grafts in hypothermic MP(HMP)without the cartridge(NoSorb);and(3)The other 2 livers stored in the ice box(NoTreat).The CK were measured at HMP start(T0)and at the end(Tend).Biopsies were taken at T0 and Tend.RESULTS All 5 grafts treated with HMP had a negative lactate trend after 3 hours of treatment(8.83 at T0 vs 6.4 at Tend of Sorb;15 at T0 vs 5.45 at Tend for NoSorb,P value>0.05).At Tend,both Sorb and NoSorb groups had better hemodynamic parameters,comparable between the two groups.Enzyme-linked immunosorbent assay analysis showed a reduction of monocyte chemotactic protein-1,tumor necrosis factor-alpha and interleukin-1βfor NoSorb group at Tend and a complete downregulation to physiological levels of the same CK in Sorb livers after 3 hours of treatment.Biopsies showed a reduction of the perisinusoidal edema for the Sorb grafts compared with the NoSorb livers.CONCLUSION These data suggest a potential protective role of treatment of grafts with MP and sorbent cartridge in reducing the inflammatory response after a severe ischemic injury.

关 键 词：Liver donor Machine perfusion Sorbent cartridge Donation after circulatory death Cytokines Ischemiareperfusion-injury 

分 类 号：R57[医药卫生—消化系统]