Experimental Study Of Subnormothermic Machine Perfusion For Preservation Of Marginal Human Donor Liver

Purpose:This study aims to explore the feasibility and efficacy of subnormothermic machine perfusion(SNMP)for preservation of marginal human donor liver.Methods:From June 2006 to February 2017,nine discarded human donor livers were included into the present study and preserved using our subnormothermic machine perfusion(SNMP).The blood gas and biochemical parameters of the perfusate were examined hourly as well as the hemodynamic parameters.Liver tissue was collected before and after perfusion for the histological comparison..Results:The perfusion device was assembled quickly and running without any failure in all the 9 cases.After 6 hours perfusion,the hepatic artery and portal venous resistance index were 32.4.7 ± 107.2 mmHg/(L/min)and 6.9±1.7 mmHg/(L/min),respectively.The perfusate pH was 7.14 ± 0.09 with blood glucose of 19.2 ± 3.4 mmol/L and lactic acid of 15.2 ± 1.6 mmol/L.The osmotic pressure remained high at 344.3 ± 7.6 mOsm/kg at the final hour.Regarding to liver function,bile secretion reached 8.2 ±2.8mL/min during the last hour with alanine aminotransferase(ALT)of 2951.1 ± 1383.2 U/L and aspartate aminotransferase(AST)of 4788.1 ± 1085.9 U/L.The adenosine deaminase(ADA)was 44.2 ± 0.8 U/L and cholinesterase(ChE)was 224.9 ± 22.7 U/L with y-glutamine transpeptidase(y-GT)of 22.9 ± 6.4 U/L.The pathological observation showed no significant changes before and after perfusion.Conclusion:Subnormothermic machine perfusion(SNMP)can effectively maintain the physiological function of human liver without developed damage.With some intervention,SNMP is expected to resuscitate the marginal human donor liver so as to expand the donor pool.