HEPATIC BLOOD-FLOW AND OXYGEN EXTRACTION RATIO DURING NORMOTHERMIC RECIRCULATION AND TOTAL-BODY COOLING AS VIABILITY PREDICTORS IN NON-HEART-BEATING DONOR PIGS

Background, Our aim was to evaluate the hepatic blood flows and oxygen metabolism of non-heart-beating donor (NHBD) pigs, with the use of ca rdiopulmonary bypass (CPB) and normothermic recirculation (NR) before total body cooling, and its relationship with recipient survival. Meth ods. Thirty-five pigs were transplanted with an allograft from NHBDs, After warm ischemia (WI) time (20, 30, or 40 min), CPB and NR were run for 30 min, After this period, the animals were cooled to 15 degrees C, In the control group (20 min of WI), the period of NR was excluded. Liver procurement was then performed. Results. Survival rate was 100% in the 20WI, 70% in the 30WI, and 50% in the 40WI. Control group surv ival rate was 0%, Hepatic artery blood flow and portal blood flow reco vered during NR, Pump blood flow during CPB increased rapidly during N R, and was significantly higher in the 20WI. When donors of the livers transplanted in ''surviving pigs'' (DSP) were compared with donors of the livers transplanted in ''nonsurviving pigs'' (DNSP), hepatic arte ry blood flow, portal blood flow, and pump blood flow were higher in t he DSP. Hepatic oxygen extraction ratio increased in the three groups with respect to baseline values, Hepatic oxygen extraction ratio was l ower in the 20WI than in the other groups and was lower in the DSP tha n in the DNSP, Conclusions. The use of a NR period before total body c ooling improves survival of liver transplantation in NHBDs, Portal blo od flow and pump blood flow measurements can predict the viability of the grafts.