Ghent University Academic Bibliography

Advanced

Flow competition between hepatic arterial and portal venous flow during hypothermic machine perfusion preservation of porcine livers

Diethard Monbaliu, Charlotte Debbaut UGent, Wim Hillewaert, Wim Laleman, MAURICIO SAINZ-BARRIGA UGent, Jacques Pirenne and Patrick Segers UGent (2012) INTERNATIONAL JOURNAL OF ARTIFICIAL ORGANS. 35(2). p.119-131
abstract
Hypothermic machine perfusion (HMP) is regarded as a better preservation method for donor livers than cold storage. During HMP, livers are perfused through the inlet blood vessels, namely the hepatic artery (HA) and the portal vein (PO. In previous HMP feasibility studies of porcine and human livers, we observed that the PV flow decreased while the HA flow increased. This flow competition restored either spontaneously or by lowering the HA pressure (P-HA). Since this phenomenon had never been observed before and because it affects the HMP stability, it is essential to gain more insight into the determinants of flow competition. To this end, we investigated the influence of the HMP boundary conditions on liver flows during controlled experiments. This paper presents the flow effects induced by increasing P-HA and by obstructing the outlet blood vessel, which is the vena cava inferior (VCI). Flow competition was evoked by increasing P-HA to 55-70 mmHg, as well as by obstructing the VCI. Remarkably, a severe obstruction resulted in a repetitive and alternating tradeoff between the HA and PV flows. These phenomena could be related to intra-sinusoidal pressure alterations. Consequently, a higher P-HA is most likely transmitted to the sinusoidal level. This increased sinusoidal pressure reduces the pressure drop between the PV and the sinusoids, leading to a decreased PV perfusion. Flow competition has not been encountered or evoked under physiological conditions and should be taken into account for the design of liver HMP protocols. Nevertheless, more research is necessary to determine the optimal parameters for stable HMP.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
72-HOUR PRESERVATION, TRANSPLANTED LIVER, RAT-LIVER, BLOOD-FLOW, COLD-STORAGE, HEART-BEATING DONORS, Hypothermic machine perfusion, Hepatic flow, Pump perfusion, Organ preservation, KIDNEY, HEMODYNAMICS, CIRCULATION, MECHANISMS
journal title
INTERNATIONAL JOURNAL OF ARTIFICIAL ORGANS
Int. J. Artif. Organs
volume
35
issue
2
pages
119 - 131
Web of Science type
Article
Web of Science id
000304786200003
JCR category
ENGINEERING, BIOMEDICAL
JCR impact factor
1.759 (2012)
JCR rank
35/77 (2012)
JCR quartile
2 (2012)
ISSN
0391-3988
DOI
10.5301/ijao.5000038
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
2057041
handle
http://hdl.handle.net/1854/LU-2057041
date created
2012-03-02 11:53:55
date last changed
2014-04-17 11:14:07
@article{2057041,
  abstract     = {Hypothermic machine perfusion (HMP) is regarded as a better preservation method for donor livers than cold storage. During HMP, livers are perfused through the inlet blood vessels, namely the hepatic artery (HA) and the portal vein (PO. In previous HMP feasibility studies of porcine and human livers, we observed that the PV flow decreased while the HA flow increased. This flow competition restored either spontaneously or by lowering the HA pressure (P-HA). Since this phenomenon had never been observed before and because it affects the HMP stability, it is essential to gain more insight into the determinants of flow competition. To this end, we investigated the influence of the HMP boundary conditions on liver flows during controlled experiments. This paper presents the flow effects induced by increasing P-HA and by obstructing the outlet blood vessel, which is the vena cava inferior (VCI). 
Flow competition was evoked by increasing P-HA to 55-70 mmHg, as well as by obstructing the VCI. Remarkably, a severe obstruction resulted in a repetitive and alternating tradeoff between the HA and PV flows. These phenomena could be related to intra-sinusoidal pressure alterations. Consequently, a higher P-HA is most likely transmitted to the sinusoidal level. This increased sinusoidal pressure reduces the pressure drop between the PV and the sinusoids, leading to a decreased PV perfusion. Flow competition has not been encountered or evoked under physiological conditions and should be taken into account for the design of liver HMP protocols. Nevertheless, more research is necessary to determine the optimal parameters for stable HMP.},
  author       = {Monbaliu, Diethard and Debbaut, Charlotte and Hillewaert, Wim and Laleman, Wim and SAINZ-BARRIGA, MAURICIO and Pirenne, Jacques and Segers, Patrick},
  issn         = {0391-3988},
  journal      = {INTERNATIONAL JOURNAL OF ARTIFICIAL ORGANS},
  keyword      = {72-HOUR PRESERVATION,TRANSPLANTED LIVER,RAT-LIVER,BLOOD-FLOW,COLD-STORAGE,HEART-BEATING DONORS,Hypothermic machine perfusion,Hepatic flow,Pump perfusion,Organ preservation,KIDNEY,HEMODYNAMICS,CIRCULATION,MECHANISMS},
  language     = {eng},
  number       = {2},
  pages        = {119--131},
  title        = {Flow competition between hepatic arterial and portal venous flow during hypothermic machine perfusion preservation of porcine livers},
  url          = {http://dx.doi.org/10.5301/ijao.5000038},
  volume       = {35},
  year         = {2012},
}

Chicago
Monbaliu, Diethard, Charlotte Debbaut, Wim Hillewaert, Wim Laleman, Mauricio Sainz-Barriga, Jacques Pirenne, and Patrick Segers. 2012. “Flow Competition Between Hepatic Arterial and Portal Venous Flow During Hypothermic Machine Perfusion Preservation of Porcine Livers.” International Journal of Artificial Organs 35 (2): 119–131.
APA
Monbaliu, Diethard, Debbaut, C., Hillewaert, W., Laleman, W., Sainz-Barriga, M., Pirenne, J., & Segers, P. (2012). Flow competition between hepatic arterial and portal venous flow during hypothermic machine perfusion preservation of porcine livers. INTERNATIONAL JOURNAL OF ARTIFICIAL ORGANS, 35(2), 119–131.
Vancouver
1.
Monbaliu D, Debbaut C, Hillewaert W, Laleman W, Sainz-Barriga M, Pirenne J, et al. Flow competition between hepatic arterial and portal venous flow during hypothermic machine perfusion preservation of porcine livers. INTERNATIONAL JOURNAL OF ARTIFICIAL ORGANS. 2012;35(2):119–31.
MLA
Monbaliu, Diethard, Charlotte Debbaut, Wim Hillewaert, et al. “Flow Competition Between Hepatic Arterial and Portal Venous Flow During Hypothermic Machine Perfusion Preservation of Porcine Livers.” INTERNATIONAL JOURNAL OF ARTIFICIAL ORGANS 35.2 (2012): 119–131. Print.