TY - JOUR
T1 - Influence of extracorporeal porcine liver perfusion on nonhuman primates
T2 - Minimizing hemolysis improves subsequent survival
AU - Nishitai, Ryuta
AU - Ikai, Iwao
AU - Terajima, Hiroaki
AU - Kanazawa, Akiyoshi
AU - Takeyama, Osamu
AU - Uesugi, Takehiko
AU - Okabe, Hiroshi
AU - Katsura, Nagato
AU - Matsushita, Takakazu
AU - Yamanokuchi, Satoshi
AU - Matsuo, Koichi
AU - Sugimoto, Shinichi
AU - Shiotani, Tomohiro
AU - Yamaoka, Yoshio
N1 - Funding Information:
Supported in part by grants no. 09557105, 10044270, 10357010, and 11470244 from the Scientific Research Fund of the Ministry of Education, Japan, and grant no. JSPS-RFTF 96I00204 from the Research for the Future of Japan Society for the Promotion of Science.
PY - 2001
Y1 - 2001
N2 - The aim of this study is to detect and analyze risk factors of direct cross-circulation between porcine liver and non-human primates before a clinical application of extracorporeal liver perfusion (ECLP) as a liver-assist method. Porcine livers were perfused with baboon blood in an ECLP system. Six healthy baboons were directly connected to the ECLP system with continuous prostaglandin E1 administration. Cross-circulation was terminated in the following circumstances: (1) hepatic arterial or portal perfusion pressures elevated to 200 or 60 mm Hg, respectively; (2) massive exudative bleeding from the graft surface; or (3) bile output decreased to less than 5 μL/h/g of liver weight. In case 1, cross-circulation was continued for 10 hours. Severe macroscopic hemolysis occurred, and serum hemoglobin (s-Hb) concentration reached a peak of 47 mg/dL. The baboon died of acute renal failure 2 days later. Histological study of the perfused porcine liver showed marked microthrombi formation. In 3 of the later 5 cases, cross-circulation was discontinued when mild macroscopic hemolysis was observed. The duration of the 5 cross-circulations was maximally 6 hours (mean, 4.4 ± 1.2 [SD] hours). Mean s-Hb concentration in the 5 cases was elevated to 14.8 ± 5.8 mg/dL at the end of cross-circulation and decreased to the baseline level within 24 hours. These 5 baboons survived without organ dysfunction or immunologic disturbance. When severe hemolysis is avoided, direct cross-circulation using the ECLP system can be achieved without serious complications in nonhuman primates.
AB - The aim of this study is to detect and analyze risk factors of direct cross-circulation between porcine liver and non-human primates before a clinical application of extracorporeal liver perfusion (ECLP) as a liver-assist method. Porcine livers were perfused with baboon blood in an ECLP system. Six healthy baboons were directly connected to the ECLP system with continuous prostaglandin E1 administration. Cross-circulation was terminated in the following circumstances: (1) hepatic arterial or portal perfusion pressures elevated to 200 or 60 mm Hg, respectively; (2) massive exudative bleeding from the graft surface; or (3) bile output decreased to less than 5 μL/h/g of liver weight. In case 1, cross-circulation was continued for 10 hours. Severe macroscopic hemolysis occurred, and serum hemoglobin (s-Hb) concentration reached a peak of 47 mg/dL. The baboon died of acute renal failure 2 days later. Histological study of the perfused porcine liver showed marked microthrombi formation. In 3 of the later 5 cases, cross-circulation was discontinued when mild macroscopic hemolysis was observed. The duration of the 5 cross-circulations was maximally 6 hours (mean, 4.4 ± 1.2 [SD] hours). Mean s-Hb concentration in the 5 cases was elevated to 14.8 ± 5.8 mg/dL at the end of cross-circulation and decreased to the baseline level within 24 hours. These 5 baboons survived without organ dysfunction or immunologic disturbance. When severe hemolysis is avoided, direct cross-circulation using the ECLP system can be achieved without serious complications in nonhuman primates.
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U2 - 10.1053/jlts.2001.25362
DO - 10.1053/jlts.2001.25362
M3 - Article
C2 - 11460229
AN - SCOPUS:0034924353
SN - 1527-6465
VL - 7
SP - 615
EP - 622
JO - Liver Transplantation
JF - Liver Transplantation
IS - 7
ER -