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Development of a new extracorporeal whole-liver perfusion system
Authors:Katsutoshi?Naruse  mailto:narusek-sur@h.u-tokyo.ac.jp"   title="  narusek-sur@h.u-tokyo.ac.jp"   itemprop="  email"   data-track="  click"   data-track-action="  Email author"   data-track-label="  "  >Email author,Yasuyuki?Sakai,Lei?Guo,Takeshi?Natori,Junichi?Shindoh,Yasuaki?Karasawa,Yuhki?Iida,Kentaro?Kojima,Kazuya?Michishita,Masatoshi?Makuuchi
Affiliation:(1) Division of Artificial Organs and Transplantation, Department of Surgery, Faculty of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan;(2) Institute of Industrial Science, University of Tokyo, Tokyo, Japan
Abstract:
We have developed a new extracorporeal whole-liver accommodation device in which a whole swine liver is placed in a physiological state by modeling the intraabdominal arrangement in the pig body, with the liver supported by a special inferior vena cava tube. Furthermore, we employed a diaphragm-type artificial heart in our system to produce pulsatile blood flow through the hepatic artery, which is considered to be indispensable to dilate peripheral vessels and supply oxygenated whole blood to the peripheral liver tissue. Beneficial effects were demonstrated in visual findings and bile juice secretion. The color of the liver surface in our system remained bright red, indicating that the liver vessels were well drained and free from congestion, and bile juice secretion was maintained at more than 10thinspml/h throughout the perfusion period. Our system exhibited excellent ammonia removal and urea nitrogen synthesis, and serum aspartate aminotransferase levels showed no increase, indicating the absence of hepatocyte destruction. Histological findings showed that the liver could expand appropriately and was free from compression caused by its own weight. In conclusion, our original liver accommodation device enabled appropriate expansion of the whole liver and supplied adequate oxygenated blood to peripheral areas by means of a pulsatile pump.
Keywords:Bioartificial liver support  Extracorporeal liver perfusion  Direct hemoperfusion  Whole swine liver  Artificial heart
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