Mun Chae Choi, Yuri Cho, Yu Seol Lee, Sat Byol Lee, Ji Yun Bang, Eun-Ki Min, Deok-Gie Kim, Jae Geun Lee, Myoung Soo Kim, Soo Han Bae, Dong Jin Joo
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In Model 1, the SCS group (n=5) underwent 5 hours of cold storage, while the EVMP group (n=9) had 1 hour of cold storage followed by 4 hours of EVMP. In Model 2, the SCS group (n=3) underwent 6 hours of cold storage, while the EVMP group (n=3) had 2 hours of cold storage followed by 4 hours of EVMP. Hemodynamic stability during perfusion, laboratory findings, and apoptosis (via TUNEL assay) after reperfusion were evaluated.</p><p><strong>Results: </strong>The EVMP system was successfully used all 12 cases without technical complications. Hemodynamic parameters remained stable throughout perfusion. In Model 2, alanine aminotransferase levels were significantly lower in the EVMP group compared to the SCS group (e.g., 134.3±27.0 U/L vs. 48.0±6.2 U/L, <i>p</i>=0.006 at 3 hours post-reperfusion). TUNEL staining revealed significantly reduced hepatic apoptosis in the EVMP group compared to the SCS group at 2 and 3 hours post-reperfusion in both models.</p><p><strong>Conclusion: </strong>This study successfully demonstrated the stability of the transplant surgeon-innovated normothermic EVMP protocol, validating its efficacy in improving organ preservation and reducing IRI in a porcine DCD sLT model.</p>","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":"66 9","pages":"574-581"},"PeriodicalIF":2.8000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12394759/pdf/","citationCount":"0","resultStr":"{\"title\":\"Development of Transplant Surgeon-Innovated Ex Vivo Machine Perfusion: Validation in a Porcine Donation after Circulatory Death-Simulated Liver Transplant Model.\",\"authors\":\"Mun Chae Choi, Yuri Cho, Yu Seol Lee, Sat Byol Lee, Ji Yun Bang, Eun-Ki Min, Deok-Gie Kim, Jae Geun Lee, Myoung Soo Kim, Soo Han Bae, Dong Jin Joo\",\"doi\":\"10.3349/ymj.2024.0397\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Ex vivo machine perfusion (EVMP) is increasingly recognized as a promising technique for enhancing the preservation and viability of donor organs, particularly in donation after circulatory death (DCD) liver transplantation (LT). 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引用次数: 0
摘要
目的:体外机器灌注(EVMP)越来越被认为是一种有前途的技术,可以提高供体器官的保存和活力,特别是在循环性死亡(DCD)肝移植(LT)后的捐赠中。本研究通过评估其在猪DCD模拟肝移植(DCD sLT)模型中保护肝功能和减少缺血再灌注损伤(IRI)的功效,验证了移植外科创新的EVMP方案。材料和方法:选用20头约克郡猪,对静态冷藏(SCS)和EVMP进行比较。模型1中,SCS组(n=5)冷藏5小时,EVMP组(n=9)冷藏1小时,EVMP处理4小时。在模型2中,SCS组(n=3)冷藏6小时,EVMP组(n=3)冷藏2小时,EVMP处理4小时。血流动力学稳定性、实验室结果和再灌注后的细胞凋亡(通过TUNEL试验)进行评估。结果:12例患者均成功应用EVMP系统,无技术并发症。血流动力学参数在整个灌注过程中保持稳定。在模型2中,EVMP组的丙氨酸转氨酶水平明显低于SCS组(再灌注后3小时,EVMP组为134.3±27.0 U/L vs. 48.0±6.2 U/L, p=0.006)。TUNEL染色显示,在再灌注后2和3小时,EVMP组与SCS组相比,肝细胞凋亡明显减少。结论:本研究成功证明了移植外科创新的恒温EVMP方案的稳定性,验证了其在猪DCD sLT模型中改善器官保存和减少IRI的有效性。
Development of Transplant Surgeon-Innovated Ex Vivo Machine Perfusion: Validation in a Porcine Donation after Circulatory Death-Simulated Liver Transplant Model.
Purpose: Ex vivo machine perfusion (EVMP) is increasingly recognized as a promising technique for enhancing the preservation and viability of donor organs, particularly in donation after circulatory death (DCD) liver transplantation (LT). This study validates a transplant surgeon-innovated EVMP protocol by assessing its efficacy in preserving liver function and reducing ischemia-reperfusion injury (IRI) in a porcine DCD-simulated liver transplant (DCD sLT) model.
Materials and methods: Twenty Yorkshire pigs were used to compare static cold storage (SCS) and EVMP. In Model 1, the SCS group (n=5) underwent 5 hours of cold storage, while the EVMP group (n=9) had 1 hour of cold storage followed by 4 hours of EVMP. In Model 2, the SCS group (n=3) underwent 6 hours of cold storage, while the EVMP group (n=3) had 2 hours of cold storage followed by 4 hours of EVMP. Hemodynamic stability during perfusion, laboratory findings, and apoptosis (via TUNEL assay) after reperfusion were evaluated.
Results: The EVMP system was successfully used all 12 cases without technical complications. Hemodynamic parameters remained stable throughout perfusion. In Model 2, alanine aminotransferase levels were significantly lower in the EVMP group compared to the SCS group (e.g., 134.3±27.0 U/L vs. 48.0±6.2 U/L, p=0.006 at 3 hours post-reperfusion). TUNEL staining revealed significantly reduced hepatic apoptosis in the EVMP group compared to the SCS group at 2 and 3 hours post-reperfusion in both models.
Conclusion: This study successfully demonstrated the stability of the transplant surgeon-innovated normothermic EVMP protocol, validating its efficacy in improving organ preservation and reducing IRI in a porcine DCD sLT model.
期刊介绍:
The goal of the Yonsei Medical Journal (YMJ) is to publish high quality manuscripts dedicated to clinical or basic research. Any authors affiliated with an accredited biomedical institution may submit manuscripts of original articles, review articles, case reports, brief communications, and letters to the Editor.