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The Development of a Multiorgan Ex Vivo Perfused Model: Results With the Porcine Liver‐Kidney Circuit Over 24 Hours
Authors:Wen Yuan Chung  Gianpiero Gravante  Dhya Al‐Leswas  Ali Arshad  Roberto Sorge  Chris C. Watson  Cristina Pollard  Matthew S. Metcalfe  Ashley R. Dennison
Affiliation:1. Department of Hepatobiliary and Pancreatic Surgery, Leicester General Hospital, University of Leicester;2. Department of Human Physiology, Laboratory of Biometry, University of Tor Vergata, , Rome, Italy;3. Haemostasis Laboratory, Level 2 Sandringham Building, Leicester Royal Infirmary, University of Leicester, , Leicester, UK
Abstract:We already developed an ex vivo liver‐kidney model perfused for 6 h in which the kidney acted as a homeostatic organ to improve the circuit milieu compared to liver alone. In the current study, we extended the multiorgan perfusions to 24 h to evaluate the results and eventual pitfalls manifesting with longer durations. Five livers and kidneys were harvested from female pigs and perfused over 24 h. The extracorporeal circuit included a centrifugal pump, heat exchanger, and oxygenator. The primary end point of the study was the evaluation of the organ functions as gathered from biochemical and acid‐base parameters. In the combined liver‐kidney circuit, the organs survived and maintained an acceptable homeostasis for different lengths of time, longer for the liver (up to 19–23 h of perfusions) than the kidney (9–13 h of perfusions). Furthermore, glucose and creatinine values decreased significantly over time (from the 5th and 9th hour of perfusion onward). The addition of a kidney to the perfusion circuit improved the biochemical environment by removing excess products from ongoing metabolic processes. The consequence is a more physiological milieu that could improve results from future experimental studies. However, it is likely that long perfusions require some nutritional support over the hours to maintain the organ's vitality and functionality throughout the experiments.
Keywords:Ex vivo  Liver  Kidney  Perfusion model  Physiology
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