A Fitness Index for Transplantation of Machine-Perfused Cadaveric Rat Livers

View/ Open
Author
Tolboom, Herman
Note: Order does not necessarily reflect citation order of authors.
Published Version
https://doi.org/10.1186/1756-0500-5-325Metadata
Show full item recordCitation
Perk, Sinem, Maria-Louisa Izamis, Herman Tolboom, Basak Uygun, Martin L. Yarmush, and Korkut Uygun. 2012. A fitness index for transplantation of machine-perfused cadaveric rat livers. BMC Research Notes 5:325.Abstract
Background: The 110,000 patients currently on the transplant waiting list reflect the critical shortage of viable donor organs. However, a large pool of unused organs, from donors after cardiac death (DCD) that are disqualified because of extensive ischemic injury, may prove transplantable after machine perfusion treatment, fundamentally impacting the availability of treatment for end-stage organ failure. Machine perfusion is an ex-vivo organ preservation and treatment procedure that has the capacity to quantitatively evaluate and resuscitate cadaveric organs for transplantation. Methods To diagnose whether an organ was fresh or ischemic, an initial assessment of liver quality was conducted via dynamic discriminant analysis. Subsequently, to determine whether the organs were sufficiently viable for successful implantation, fitness indices for transplantation were calculated based on squared prediction errors (SPE) for fresh and ischemic livers. Results: With just three perfusate metabolites, glucose, urea and lactate, the developed MPLSDA model distinguished livers as fresh or ischemic with 90% specificity. The SPE analyses revealed that fresh livers with SPEF < 10.03 and WI livers with SPEWI < 3.92 yield successful transplantation with 95% specificity. Conclusions: The statistical methods used here can discriminate between fresh and ischemic livers based on simple metabolic indicators measured during perfusion. The result is a predictive fitness index for transplantation of rat livers procured after cardiac death. The translational implications of this study are that any donor organ procured from controlled, but most especially from uncontrolled cardiac death donors, will be objectively assessed and its recovery monitored over time, minimizing the critical loss of otherwise viable organs.Other Sources
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3441584/pdf/Terms of Use
This article is made available under the terms and conditions applicable to Other Posted Material, as set forth at http://nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of-use#LAACitable link to this page
http://nrs.harvard.edu/urn-3:HUL.InstRepos:10536048
Collections
- HMS Scholarly Articles [17767]
Contact administrator regarding this item (to report mistakes or request changes)