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- W2895522439 abstract "Introduction: Livers procured after cardiac death suffer extreme degree of ischemia - reperfusion injury (IRI) and at increased risk of graft failure after liver transplantation (LT). Regulated hepatic reperfusion (RHR) is a novel organ resuscitation therapy that facilitates hepatic mitochondrial and microcirculatory recovery from IRI using an energy substrate-enriched, leukocyte-depleted, oxygen-saturated perfusate delivered in a pressure, and temperature -controlled milieu. Methods: Using a swine donation after cardiac (DCD) model, all livers were subjected to 1 hour of in situ warm ischemia and 2 hours of cold static (CS) preservation. All livers were subsequently reperfused and monitored for 2 hours in the ex vivo perfusion machine. Four methods of reperfusion were compared. 5 animals in each treatment group. Group I: Sanguineous-Subnormothermic (SS); Group II: RHR-Subnormothermic (RHR-S); Group III: Sanguineous-Normothermic (SN); Group IV: RHR-Normothermic (RHR-N). We analyzed the effects of RHR on post-reperfusion biochemical, metabolic, immunological and histological profiles and mitochondrial function. Results: Compared to Groups I, III, and IV, Group II (RHR-S) significantly mitigated IRI: AST (p=0.04), total bilirubin (p=0.03), TNF-alpha (p< 0.01), IL-10 (p< 0.01); and IL-6 (p< 0.01). Mitochondrial calcium retention capacity and respiration confirmed preservation of mitochondrial function in Group II. Histopathological evaluation of hepatocyte viability showed minimal ischemic changes in Group II; however, a significant degree of hepatocyte necrosis was observed the other groups. Conclusion: Ex Vivo subnormothermic regulated hepatic reperfusion mitigates IRI, preserves mitochondrial function and facilitates liver function recovery after donation after cardiac death. This novel strategy has potential applicability to human liver transplantation." @default.
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- W2895522439 date "2018-09-01" @default.
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- W2895522439 title "Ex vivo subnormothermic regulated hepatic reperfusion is superior to normothermic machine perfusion: a novel concept of liver resuscitation after cardiac death in large animal model" @default.
- W2895522439 doi "https://doi.org/10.1016/j.hpb.2018.06.055" @default.
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