A fitness index for transplantation of machine-perfused cadaveric rat livers

BMC Research Notes

Korkut Uygun³  Martin L Yarmush¹  Basak Uygun³  Herman Tolboom²  Maria-Louisa Izamis³  Sinem Perk³ 

[1] Department of Biomedical Engineering, Rutgers University, Piscataway, NJ, USA;Division of Cardiac and Vascular Surgery, University Hospital Zurich, Zurich, Switzerland;Center for Engineering in Medicine, Massachusetts General Hospital, Harvard Medical School, and the Shriners Hospitals for Children, 51 Blossom Street, Boston, MA, 02114, USA

关键词: Donors after cardiac death;    Extracorporeal liver perfusion;    Partial least squares (PLS);    Principal component analysis (PCA);    Transplantation index;   

Others  :  1166227
DOI  :  10.1186/1756-0500-5-325

 received in 2011-11-10, accepted in 2012-05-28,  发布年份 2012

【 摘 要 】

Background

The 110,000 patients currently on the transplant waiting list reflect the critical shortage of viable donor organs. However, a large pool of unused organs, from donors after cardiac death (DCD) that are disqualified because of extensive ischemic injury, may prove transplantable after machine perfusion treatment, fundamentally impacting the availability of treatment for end-stage organ failure. Machine perfusion is an ex-vivo organ preservation and treatment procedure that has the capacity to quantitatively evaluate and resuscitate cadaveric organs for transplantation.

Methods

To diagnose whether an organ was fresh or ischemic, an initial assessment of liver quality was conducted via dynamic discriminant analysis. Subsequently, to determine whether the organs were sufficiently viable for successful implantation, fitness indices for transplantation were calculated based on squared prediction errors (SPE) for fresh and ischemic livers.

Results

With just three perfusate metabolites, glucose, urea and lactate, the developed MPLSDA model distinguished livers as fresh or ischemic with 90% specificity. The SPE analyses revealed that fresh livers with SPE_F < 10.03 and WI livers with SPE_WI < 3.92 yield successful transplantation with 95% specificity.

Conclusions

The statistical methods used here can discriminate between fresh and ischemic livers based on simple metabolic indicators measured during perfusion. The result is a predictive fitness index for transplantation of rat livers procured after cardiac death. The translational implications of this study are that any donor organ procured from controlled, but most especially from uncontrolled cardiac death donors, will be objectively assessed and its recovery monitored over time, minimizing the critical loss of otherwise viable organs.

【 授权许可】

   
2012 Perk et al.; licensee BioMed Central Ltd.

【 图 表 】

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