Gradual rewarming with a hemoglobin-based oxygen carrier improves viability of donation after circulatory death in rat livers

使用基于血红蛋白的氧载体逐渐复温可提高大鼠肝脏循环死亡后捐献的可行性

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作者:Paria Mahboub, Mohamed Aburawi, O Sila Ozgur, Casie Pendexter, Stephanie Cronin, Florence Min Lin, Rohil Jain, Murat N Karabacak, Negin Karimian, Shannon N Tessier, James F Markmann, Heidi Yeh, Korkut Uygun

Background

Donation after circulatory death (DCD) grafts are vital for increasing available donor organs. Gradual rewarming during machine perfusion has proven effective in mitigating reperfusion injury and enhancing graft quality. Limited data exist on artificial oxygen carriers as an effective solution to meet the increasing metabolic demand with temperature changes. The

Conclusion

This study suggests the safety of using HBOC during rewarming perfusion of rat livers as no harmful effect was detected. Furthermore, the viability assessment indicated improvement in graft function.

Methods

Liver grafts were procured after 30 min of warm ischemia. The effect of 90 min of oxygenated rewarming perfusion from ice cold temperatures (4 °C) to 37 °C with HBOC after cold storage was evaluated and the

Results

Gradual rewarming with HBOC significantly enhanced recovery, demonstrated by markedly lower lactate levels and reduced vascular resistance compared to cold-stored liver grafts. Increased bile production in the HBOC group was noted, indicating improved liver function and bile synthesis capacity. Histological examination showed reduced cellular damage and better tissue preservation in the HBOC-treated livers compared to those subjected to cold storage alone.

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