Evidence map›Paper›PMID 38988689›Full record

ArticleTransplantation direct2024

Optimizing DCD Liver Grafts With Prolonged Warm Ischemic Time Using Stabilized Plasmin in a Static Cold Storage Orthotopic Rat Liver Transplant Model.

Riley Kahan, Nader Abraham, Min Zhang, Valery Novokhatny, Isaac Alderete, Paul Cray, Fengming Chen, Qimeng Gao, Greta Cywinska, Ryan Neill and 8 more

Abstract read
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Article in Transplantation direct, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

18 authors.

Riley KahanDepartment of Surgery, Duke University, Durham, NC.ORCID https://orcid.org/0009-0002-7777-4226
Nader AbrahamDepartment of Surgery, Duke University, Durham, NC.
Min ZhangDepartment of Surgery, Duke University, Durham, NC.
Valery NovokhatnyGrifols Scientific Innovation Office, Grifols, NC.
Isaac AldereteDepartment of Surgery, Duke University, Durham, NC.
Paul CrayDepartment of Surgery, Duke University, Durham, NC.
Fengming ChenDepartment of Pathology, Duke University, Durham, NC.
Qimeng GaoDepartment of Surgery, Duke University, Durham, NC.
Greta CywinskaDepartment of Surgery, Duke University, Durham, NC.
Ryan NeillDepartment of Surgery, Duke University, Durham, NC.
Kentaro NakataDepartment of Surgery, Duke University, Durham, NC.
Ahmed HassanDepartment of Surgery, Duke University, Durham, NC.
Caroline RushDepartment of Surgery, Duke University, Durham, NC.
Jude PenaflorDepartment of Surgery, Duke University, Durham, NC.
Justin J PollaraDepartment of Surgery, Duke University, Durham, NC.
Matthew G HartwigDepartment of Surgery, Duke University, Durham, NC.
Benjamin HughesDepartment of Surgery, Duke University, Durham, NC.
Andrew S BarbasDepartment of Surgery, Duke University, Durham, NC.ORCID https://orcid.org/0000-0003-3476-2313

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The clinical success of liver transplantation has led to increased demand, requiring further expansion of the donor pool. Therapeutic interventions to optimize organs from donation after circulatory death (DCD) have significant potential to mitigate the organ shortage. Dysfunction in DCD liver grafts is mediated by microvascular thrombosis during the warm ischemic period, and strategies that reduce this thrombotic burden may improve graft function. We hypothesized that the administration of the fibrinolytic enzyme plasmin to the donor organ during the cold storage period would reduce the thrombotic burden and improve DCD liver graft function. Methods: In 2 separate cohorts, 32 syngeneic orthotopic rat liver transplants were performed in Lewis rats. Livers were procured from donors with 45 min of warm ischemic injury. Liver grafts were flushed with histidine-tryptophan-ketoglutarate preservation solution mixed with either plasmin (experimental group) or albumin (control group). All investigators were blinded to treatment group. After preparing the liver for implant using a modified cuff technique, the liver was stored for 1 h by static cold storage at 4 °C. Immediately before implantation, the liver graft was flushed, and this effluent was analyzed for fibrin degradation products to determine graft clot burden. Twenty-four hours following transplantation, animals were euthanized, and samples were collected. Results: Recipient survival was significantly higher for DCD liver grafts treated with plasmin compared with control. Moreover, histology of liver graft tissue immediately before implant reflected significantly reduced congestion in plasmin-treated livers (score, mean ± SD: 0.73 ± 0.59 versus 1.12 ± 0.48; Conclusions: The present study demonstrates that plasmin improves survival and may reduce thrombotic burden in DCD liver grafts with prolonged warm ischemic injury, meriting further study.

Identifiers

PMID38988689
PMCPMC11230777

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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.