Evidence map›Paper›PMID 31386697›Full record

ArticlePloS one2019

Avoiding initial hypothermia does not improve liver graft quality in a porcine donation after circulatory death (DCD) model of normothermic perfusion.

Jordan J Nostedt, Tom Churchill, Sunita Ghosh, Aducio Thiesen, Jessica Hopkins, Mackenzie C Lees, Benjamin Adam, Darren H Freed, A M James Shapiro, David L Bigam

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.1field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
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  5. Article
  6. Annals of translational medicine · 2021
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Jordan J NostedtDepartment of Surgery, Division of General Surgery, University of Alberta, Edmonton AB, Canada.ORCID 0000-0002-3984-5700
Tom ChurchillDepartment of Surgery, Division of Surgical Research, University of Alberta, Edmonton AB, Canada.
Sunita GhoshDepartment of Mathematics and Statistical Sciences, University of Alberta, Edmonton AB, Canada.
Aducio ThiesenDepartment of Laboratory Medicine and Pathology, University of Alberta, Edmonton AB, Canada.
Jessica HopkinsDepartment of Surgery, Division of General Surgery, University of Alberta, Edmonton AB, Canada.
Mackenzie C LeesDepartment of Surgery, Division of General Surgery, University of Alberta, Edmonton AB, Canada.
Benjamin AdamDepartment of Laboratory Medicine and Pathology, University of Alberta, Edmonton AB, Canada.
Darren H FreedDepartment of Physiology, University of Alberta, Edmonton AB, Canada.ORCID 0000-0002-6239-1444
A M James ShapiroDepartment of Surgery, Division of General Surgery, University of Alberta, Edmonton AB, Canada.
David L BigamDepartment of Surgery, Division of General Surgery, University of Alberta, Edmonton AB, Canada.
University of Alberta · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNormothermic machine perfusion (NMP) of liver grafts donated after circulatory death (DCD) has shown promise in large animal and clinical trials. Following procurement, initial flush with a cold preservation solution is the standard of care. There is concern that initial cooling followed by warming may exacerbate liver injury, and the optimal initial flush temperature has yet to be identified. We hypothesize that avoidance of the initial cold flush will yield better quality liver grafts.

methodsTwenty-four anaesthetized pigs were withdrawn from mechanical ventilation and allowed to arrest. After 60-minutes of warm ischemia to simulate a DCD procurement, livers were flushed with histidine-tryptophan-ketoglutarate (HTK) at 4°C, 25°C or 35°C (n = 4 per group). For comparison, an adenosine-lidocaine crystalloid solution (AD), shown to have benefit at warm temperatures in heart perfusions, was also used (n = 4 per group). During 12-hours of NMP, adenosine triphosphate (ATP), lactate, transaminase levels, and histological injury were determined. Bile production and hemodynamics were monitored continuously.

resultsATP levels recovered substantially following 1-hour of NMP reaching pre-ischemic levels by the end of NMP with no difference between groups. There was no difference in peak aspartate aminotransferase (AST) or in lactate dehydrogenase (LDH). Portal vein resistance was lowest in the 4°C group reaching significance after 2 hours (0.13 CI -0.01,0.277, p = 0.025). Lactate levels recovered promptly with no difference between groups. Comparison to AD groups showed no statistical difference in the abovementioned parameters. On electron microscopy the HTK4°C group had the least edema with mean cell thickness of 2.92μm (p = 0.41) while also having the least sinusoidal dilatation with a mean diameter of 5.36μm (p = 0.04). For AD, the 25°C group had the lowest mean cell thickness at 3.14μm (p = 0.09).

conclusionsAvoidance of the initial cold flush failed to demonstrate added benefit over standard 4°C HTK in this DCD model of liver perfusion.

Indexed as

HypothermiaTemperatureAdenosine TriphosphateAnimalsAspartate AminotransferasesDeathLiverLiver TransplantationL-Lactate DehydrogenaseOrgan PreservationOrgan Preservation SolutionsPerfusionSwineAdenosine TriphosphateAspartate AminotransferasesL-Lactate DehydrogenaseOrgan Preservation Solutions

Identifiers

PMID31386697
PMCPMC6684160
OpenAlexW2964776886

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.