Clinical assessment of liver metabolism during hypothermic oxygenated machine perfusion using microdialysis

Damiano Patrono, Dorotea Roggio, Anna Teresa Mazzeo, Giorgia Catalano, Elena Mazza, Giorgia Rizza, Alessandro Gambella, Federica Rigo, Nicola Leone, Vincenzo Elia, Daniele Dondossola, Caterina Lonati, Vito Fanelli, Renato Romagnoli

Research output: Contribution to journalArticlepeer-review

Abstract

Background: While growing evidence supports the use of hypothermic oxygenated machine perfusion (HOPE) in liver transplantation, its effects on liver metabolism are still incompletely understood. Methods: To assess liver metabolism during HOPE using microdialysis (MD), we conducted an open-label, observational pilot study on 10 consecutive grafts treated with dual-HOPE (D-HOPE). Microdialysate and perfusate levels of glucose, lactate, pyruvate, glutamate, and flavin mononucleotide (FMN) were measured during back table preparation and D-HOPE and correlated to graft function and patient outcome. Results: Median (IQR) MD and D-HOPE time was 228 (210, 245) and 116 (103, 143) min. Three grafts developed early allograft dysfunction (EAD), with one requiring retransplantation. During D-HOPE, MD glucose and lactate levels increased (ANOVA = 9.88 [p = 0.01] and 3.71 [p = 0.08]). Their 2nd-hour levels were higher in EAD group and positively correlated with L-GrAFT score. 2nd-hour MD glucose and lactate were also positively correlated with cold ischemia time, macrovesicular steatosis, weight gain during D-HOPE, and perfusate FMN. These correlations were not apparent when perfusate levels were considered. In contrast, MD FMN levels invariably dropped steeply after D-HOPE start, whereas perfusate FMN was higher in dysfunctioning grafts. Conclusion: MD glucose and lactate during D-HOPE are markers of hepatocellular injury and could represent additional elements of the viability assessment.

Original languageEnglish
Pages (from-to)281-295
JournalArtificial Organs
Volume46
Issue number2
DOIs
Publication statusPublished - 2022

Keywords

  • extracellular fluid
  • flavin mononucleotide
  • liver metabolism
  • liver viability assessment
  • machine perfusion
  • microdialysis

ASJC Scopus subject areas

  • Bioengineering
  • Medicine (miscellaneous)
  • Biomaterials
  • Biomedical Engineering

Fingerprint

Dive into the research topics of 'Clinical assessment of liver metabolism during hypothermic oxygenated machine perfusion using microdialysis'. Together they form a unique fingerprint.

Cite this