NDLI: Characterization of the Withdrawal Phase in a Porcine Donation after the Cardiac Death Model

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Characterization of the Withdrawal Phase in a Porcine Donation after the Cardiac Death Model

Content Provider	Scilit
Author	Rhee, J. Y. Alroy, J. Freeman, R. B.
Copyright Year	2011
Description	Journal: American Journal of Transplantation Transplantation of donation after cardiac death (DCD) livers has higher rates of organ failure and complications, specifically ischemic biliary injuries. Reported large animal DCD models all employ active means to halt circulation, contrary to human DCD protocol. We report a DCD porcine model in which the animal passively progresses to cardiac death, thereby more closely mimicking human DCD scenario. Sixteen Yorkshire pigs (10 females, 6 males, 30–45 kg) had a mean time of 26:19 min ± 14:14 from withdrawal of ventilatory support (WVS) to circulatory arrest and 44:38 min ± 16:37 from WVS to electrical standstill. Cessation of hepatic flow (HF) occurred well before electrical standstill (22:15 min ± 10:09), previously not described in human or animal DCD. Histologically comparing livers from our DCD model demonstrated a dramatic increase in hepatocyte vacuolization, disorganization of endoplasmic reticulum, formation of mitochondrial inclusions and apoptosis compared with control specimens. Subtle changes were also evident in biliary epithelial cells (BEC). This results in severe cellular changes before reperfusion. Early histologic evidence suggests that there is severe hepatocyte and biliary cell disruption in our DCD model. Further research using this model may provide a deeper understanding of the pathophysiology of the DCD liver.
Ending Page	1175
Starting Page	1169
ISSN	2573508X
e-ISSN	16006143
DOI	10.1111/j.1600-6143.2011.03567.x
Journal	American Journal of Transplantation
Issue Number	6
Volume Number	11
Language	English
Publisher	Wiley-Blackwell
Publisher Date	2011-06-06
Access Restriction	Open
Subject Keyword	Journal: American Journal of Transplantation Non-heart-beating Donor
Content Type	Text
Resource Type	Article

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