Association of Perfusion Characteristics and Posttransplant Liver Function in Ischemia-Free Liver Transplantation

Zhiheng Zhang, Yunhua Tang, Qiang Zhao, Linhe Wang, Caihui Zhu, Weiqiang Ju, Dongping Wang, Lu Yang, Linwei Wu, Maogen Chen, Shanzhou Huang, Ningxin Gao, Zebin Zhu, Yixi Zhang, Chengjun Sun, Wei Xiong, Yuekun Shen, Yi Ma, Anbin Hu, Xiaofeng ZhuJian Rong, Changjie Cai, Zhiyong Guo, Xiaoshun He

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

It has been shown that normothermic machine perfusion (NMP), a novel preservation method, is able to assess and resuscitate liver grafts with risk factors. However, there is no consistent criteria for the assessment of liver grafts with NMP. Ischemia-free liver transplantation (IFLT) includes innovative surgical techniques and NMP, which can protect liver grafts from ischemia throughout organ procurement, preservation, and implantation. In our center, 28 human livers from donation after brain death donors were subjected to IFLT between July 2017 and October 2018. The correlation between posttransplant liver function tests with the perfusion parameters, blood gas analysis of perfusate, and bile biochemistry were analyzed. During the preservation phase, the vascular flow was stable, and the lactate level decreased rapidly. The transaminase release in the perfusate was low but stable, whereas the glucose level remained high. The perfusate lactate and aspartate aminotransferase (AST) levels at 1 hour of perfusion were correlated with the posttransplant peak AST level. There were negative correlations between the portal vein and hepatic artery flows at the end of perfusion and the peak transaminase levels within 7 days after transplantation. In conclusion, during IFLT, NMP is able to bridge the liver grafts from donors to recipients and can allow the assessment of liver function by perfusion characteristics.

Original languageEnglish (US)
Pages (from-to)1441-1454
Number of pages14
JournalLiver Transplantation
Volume26
Issue number11
DOIs
StatePublished - Nov 1 2020

ASJC Scopus subject areas

  • Surgery
  • Hepatology
  • Transplantation

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