Liver conditioning after cardiac arrest: The use of normothermic recirculation in an experimental animal model

Juan Carlos García-Valdecasas, Jeanine Tabet, Ricardo Valero, Pilar Taurá, Ramón Rull, Félix García, Elena Montserrat, Francisco X. González, Jaume Ordi, Joan Beltran, Miguel A. López-Boado, Ramón Deulofeu, Joaquín Angás, Andrés Cifuentes, José Visa

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    60 Citations (Scopus)

    Abstract

    The aim of this study was to compare the possible role of normothermic recirculation with the role of liver transplants from non-heart-beating donor pigs after 20 min of cardiac arrest. Three groups were studied, of which two were control groups: group 1, in which the liver was harvested from a heart-beating donor; group 2, in which the liver was harvested after a period of cardiac arrest followed by total body cooling; and group 3, in which the liver was procured as in group 2, but including a period of 30 min of cardiopulmonary bypass and tissue oxygenation at 37°C before total body cooling. Survival at 5 days; endothelial (hyaluronic acid) and hepatocellular damage (AST, ALT, and α-GST); adenine nucleotides (energy charge), and histological changes were evaluated. Normothermic recirculation during 30 min showed a significant effect on survival (p = .03), endothelial damage (p < .05), and histological changes after reperfusion (p = .04). Cardiopulmonary bypass significantly increased the energy charge during the normothermic recirculation period (p = .001). Moreover, this study shows that a significant survival (100%) can be achieved with a liver allograft after 20 min of cardiac arrest. Although the liver suffers a major insult in terms of endothelial damage and hepatocellular damage, lesions caused by the ischemic injury are reversible. Histological changes also indicate lesion reversibility, since they almost disappear after 5 days.
    Original languageEnglish
    Pages (from-to)424-432
    JournalTransplant International
    Volume11
    DOIs
    Publication statusPublished - 1 Nov 1998

    Keywords

    • Cardiac arrest, liver donation
    • Liver conditioning
    • Liver transplantation, experimental
    • Normothermic recirculation

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