Abstract
BACKGROUND: Organs harvested from a body lapsing into circulatory deficit are exposed to low O2/high CO2, and reach a critical point where original functionality after transplantation is unlikely. The present study evaluates the effect of respiratory assistance using Chlorella photosynthesis on preservation of the rat pancreas from the viewpoint of donation after cardiac death (DCD). METHODS: Gas was exchanged through the peritoneum of rats under controlled ventilation with or without Chlorella photosynthetic respiratory assistance. A gas permeable pouch containing Chlorella in solution was placed in the peritoneum and then the space between the pouch and the peritoneum was filled with an emulsified perfluorocarbon gas carrier. Rat DCD pancreases procured 3 h after cardiac arrest were preserved for 30 min in a cold or mildly hypothermic environment or in a mildly hypothermic environment with photosynthetic respiratory support. The pancreases were then heterotopically transplanted into rats with STZ-induced diabetes. RESULTS: Levels of blood oxygen (PaO2) and carbon dioxide (PaCO2) increased and significantly decreased, respectively, in rats with mechanically reduced ventilation and rats given intraperitoneal photosynthetic respiratory support when compared with those without such support. Transplantation with DCD pancreases that had been stored under photosynthetic respiratory support resulted in the survival of all rats, which is impossible to achieve using pancreases that have been maintained statically in cold storage. CONCLUSION: Respiratory assistance using photosynthesis helps to improve not only blood gas status in the event of respiratory insufficiency, but also graft recovery after pancreas transplantation with a DCD pancreas that has been damaged by prolonged warm ischemia.