Metformin Preconditioning Improves Hepatobiliary Function and Reduces Injury in a Rat Model of Normothermic Machine Perfusion and Orthotopic Transplantation

Conclusions. Preconditioning with metformin lowers hepatobiliary injury and improves hepatobiliary function in an in situ and ex situ model of rat donor liver transplantation.
Source: Transplantation - Category: Transplant Surgery Tags: Original Basic Science—Liver Source Type: research

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ConclusionsThe non-cirrhotic livers from pediatric patients with metabolic liver disease can be used as domino donor grafts for selected pediatric patients with different metabolic liver disease. D-APOLT achieves ideal recipient outcomes and provides a strategy to expand donor source for children.
Source: Pediatric Surgery International - Category: Surgery Source Type: research
AbstractThe introduction of hepatobiliary contrast agents, most notably gadoxetic acid (GA), has expanded the role of MRI, allowing not only a morphologic but also a functional evaluation of the hepatobiliary system. The mechanism of uptake and excretion of gadoxetic acid via transporters, such as organic anion transporting polypeptides (OATP1,3), multidrug resistance-associated protein 2  (MRP2) and MRP3, has been elucidated in the literature. Furthermore, GA uptake can be estimated on either static images or on dynamic imaging, for example, the hepatic extraction fraction (HEF) and liver perfusion. GA-enhanced MRI h...
Source: Abdominal Imaging - Category: Radiology Source Type: research
Hepatic steatosis (HS) is a key factor predicting postoperative allograft function and determining overall discard in liver transplantation (LT). The potential of normothermic machine perfusion (NMP) as an adjunct to LT has been a focus of recent scrutiny due to its ability to attenuate ischemia reperfusion injuries (IRI) and maintain graft functionality. The nuclear-factor-erythroid 2-related-factor-2 (Nrf2) axis may be an important IRI mediator in HS. We aimed to characterize and compare Nrf2 expression profiles between lean and steatotic tissue undergoing NMP.
Source: Journal of the American College of Surgeons - Category: Surgery Authors: Tags: Transplantation and tissue engineering Source Type: research
Purpose of review To review the role of machine perfusion in advancing the study and clinical application of liver xenotransplantation to liver transplantation. Recent findings Recent multicenter trial has shown the benefits of normothermic machine perfusion (NMP) in the assessment and selection of suitable allografts for liver transplantation, especially marginal liver allografts. Advances in ex-vivo therapeutic intervention with proof-of-concept studies demonstrating successful ex-vivo genetic modification of donor allografts and blockade of gene expression with siRNA. Summary Xenotransplantation and NMP are two ...
Source: Current Opinion in Organ Transplantation - Category: Surgery Tags: XENOTRANSPLANTATION: Edited by Parsia A. Vagefi Source Type: research
er U Abstract Liver transplantation has become established as a standard procedure in the treatment of end-stage liver diseases. Despite intense efforts by all parties involved up to the amendment of the German Transplantation Act, the lack of suitable donor organs was still one of the limiting factors of this therapeutic procedure. One way out of this problem is to make so-called marginal organs usable, e.g. with the help of machine perfusion or by utilizing living liver donation, which are used in some countries for more than 90% of organ donations. In general, there is no difference in the indications for ...
Source: Der Chirurg - Category: Surgery Authors: Tags: Chirurg Source Type: research
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Source: Transplantation - Category: Transplant Surgery Tags: Letters to the Editor Source Type: research
Conclusions. NMP in a multidisciplinary approach enables a safe prolongation of liver preservation and overnight organ care. A first field test of NMP indicates safety and benefit of this approach.
Source: Transplantation - Category: Transplant Surgery Tags: Original Clinical Science—Liver Source Type: research
Background. Liver graft viability assessment has long been considered a limit of hypothermic oxygenated machine perfusion (HOPE). Aim of this study was assessing correlations of easily available perfusate parameters (PP) (aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, glucose, lactate, and pH) with graft features and outcome. Methods. In the period October 2018–February 2020, perfusate samples were obtained every 30 minutes during 50 dual-HOPE (D-HOPE) procedures. Correlations of PP with graft factors, 90-day graft loss, early allograft dysfunction (EAD), L-GrAFT score, acute kidney...
Source: Transplantation - Category: Transplant Surgery Tags: Original Clinical Science—Liver Source Type: research
Background. Liver transplantation (LT) from controlled donation after circulatory death (cDCD) was initiated in France in 2015 under a protocol based on the use of normothermic regional perfusion (NRP) before organ procurement. The aim was to compare outcomes following cDCD LT with NRP and donation after brain death (DBD) LT. Methods. This is a multicenter retrospective study comparing cDCD LT with NRP and DBD LT. A case-matched study (1:2) was performed using the variables such as recipient and donor age, indication of LT. Results. A total of 50 patients from the cDCD group were matched to 100 patients from the DB...
Source: Transplantation - Category: Transplant Surgery Tags: Original Clinical Science—Liver Source Type: research
Because of the high demand of organs, the usage of marginal grafts has increased. These marginal organs have a higher risk of developing ischemia-reperfusion injury, which can lead to posttransplant complications. Ex situ machine perfusion (MP), compared with the traditional static cold storage, may better protect these organs from ischemia-reperfusion injury. In addition, MP can also act as a platform for dynamic administration of pharmacological agents or gene therapy to further improve transplant outcomes. Numerous therapeutic agents have been studied under both hypothermic (1–8°C) and normothermic settings. H...
Source: Transplantation - Category: Transplant Surgery Tags: Reviews Source Type: research
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