Oxygen Transport during Ex Situ Machine Perfusion of Donor Livers Using Red Blood Cells or Artificial Oxygen Carriers

被引:29
作者
Bodewes, Silke B. [1 ,2 ]
van Leeuwen, Otto B. [1 ,3 ]
Thorne, Adam M. [1 ,3 ]
Lascaris, Bianca [1 ,3 ]
Ubbink, Rinse [3 ]
Lisman, Ton [2 ]
Monbaliu, Diethard [4 ,5 ]
De Meijer, Vincent E. [1 ]
Nijsten, Maarten W. N. [6 ]
Porte, Robert J. [1 ]
机构
[1] Univ Groningen, Univ Med Ctr Groningen, Sect Hepatobiliary Surg & Liver Transplantat, Dept Surg, NL-9713 GZ Groningen, Netherlands
[2] Univ Groningen, Univ Med Ctr Groningen, Dept Surg, Surg Res Lab, NL-9713 GZ Groningen, Netherlands
[3] Univ Med Ctr Groningen, Organ Preservat & Resuscitat Unit, NL-9713 GZ Groningen, Netherlands
[4] Univ Hosp Leuven, Dept Abdominal Transplantat Surg & Coordinat, B-3000 Leuven, Belgium
[5] Katholieke Univ Leuven, Transplantat Res Grp, Dept Microbiol Immunol & Transplantat, B-3000 Leuven, Belgium
[6] Univ Groningen, Univ Med Ctr Groningen, Dept Crit Care, NL-9713 GZ Groningen, Netherlands
关键词
machine perfusion; liver; gas transport; artificial oxygen carriers; oxygen; carbon dioxide; temperature; STATIC COLD-STORAGE; HEMOGLOBIN VESICLES; ORGAN PRESERVATION; PORCINE LIVERS; NITRIC-OXIDE; TRANSPLANTATION; DEATH; TEMPERATURE; SUBSTITUTES; DONATION;
D O I
10.3390/ijms22010235
中图分类号
Q5 [生物化学]; Q7 [分子生物学];
学科分类号
071010 ; 081704 ;
摘要
Oxygenated ex situ machine perfusion of donor livers is an alternative for static cold preservation that can be performed at temperatures from 0 degrees C to 37 degrees C. Organ metabolism depends on oxygen to produce adenosine triphosphate and temperatures below 37 degrees C reduce the metabolic rate and oxygen requirements. The transport and delivery of oxygen in machine perfusion are key determinants in preserving organ viability and cellular function. Oxygen delivery is more challenging than carbon dioxide removal, and oxygenation of the perfusion fluid is temperature dependent. The maximal oxygen content of water-based solutions is inversely related to the temperature, while cellular oxygen demand correlates positively with temperature. Machine perfusion above 20 degrees C will therefore require an oxygen carrier to enable sufficient oxygen delivery to the liver. Human red blood cells are the most physiological oxygen carriers. Alternative artificial oxygen transporters are hemoglobin-based oxygen carriers, perfluorocarbons, and an extracellular oxygen carrier derived from a marine invertebrate. We describe the principles of oxygen transport, delivery, and consumption in machine perfusion for donor livers using different oxygen carrier-based perfusion solutions and we discuss the properties, advantages, and disadvantages of these carriers and their use.
引用
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页码:1 / 15
页数:15
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