Synthesis of coagulation factors during long-term ex situ liver perfusion.
coagulation factors
ex situ
liver perfusion
synthetic function
Journal
Artificial organs
ISSN: 1525-1594
Titre abrégé: Artif Organs
Pays: United States
ID NLM: 7802778
Informations de publication
Date de publication:
Feb 2022
Feb 2022
Historique:
revised:
10
06
2021
received:
25
02
2021
accepted:
06
07
2021
pubmed:
22
7
2021
medline:
1
2
2022
entrez:
21
7
2021
Statut:
ppublish
Résumé
Robust viability assessment of grafts during normothermic liver perfusion is a prerequisite for organ use. Coagulation parameters are used commonly for liver assessment in patients. However, they are not yet included in viability assessment during ex situ perfusion. In this study, we analysed coagulation parameters during one week ex situ perfusion at 34℃. Eight discarded human livers were perfused with blood-based, heparinised perfusate for one week; perfusions in a further four livers were terminated on day 4 due to massive ongoing cell death. Coagulation parameters were well below the physiologic range at perfusion start. Physiologic levels were achieved within the first two perfusion days for factor V (68.5 ± 35.5%), factor VII (83.5 ± 26.2%), fibrinogen (2.1 ± 0.4 g/L) and antithrombin (107 ± 26.5%) in the livers perfused for one week. Despite the increased production of coagulation factors, INR was detectable only at 24h of perfusion (2.1 ± 0.3) and prolonged thereafter (INR > 9). The prolongation of INR was related to the high heparin level in the perfusate (anti-FXa > 3 U/mL). Intriguingly, livers with ongoing massive cell death also disclosed synthesis of factor V and improved INR. In summary, perfused livers were able to produce coagulation factors at a physiological level ex situ. We propose that single coagulation factor analysis is more reliable for assessing the synthetic function of perfused livers as compared to INR when using a heparinised perfusate.
Substances chimiques
Blood Coagulation Factors
0
Heparin
9005-49-6
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
273-280Subventions
Organisme : The study was funded by grants from Wyss Zurich, PROMEDICA Foundation and Helmut Horten Foundation. We highly acknowledge this financial support.
Informations de copyright
© 2021 International Center for Artificial Organs and Transplantation and Wiley Periodicals LLC.
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