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Oxygen Transport during Ex Situ Machine Perfusion of Donor Livers Using Red Blood Cells or Artificial Oxygen Carriers

1
Section of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands
2
Surgical Research Laboratory, Department of Surgery, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands
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Organ Preservation & Resuscitation Unit, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands
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Department of Abdominal Transplantation Surgery and Coordination, University Hospitals Leuven, 3000 Leuven, Belgium
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Transplantation Research Group, Department of Microbiology, Immunology, and Transplantation, Katholieke Universiteit Leuven, 3000 Leuven, Belgium
6
Department of Critical Care, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands
*
Author to whom correspondence should be addressed.
Int. J. Mol. Sci. 2021, 22(1), 235; https://doi.org/10.3390/ijms22010235
Received: 16 November 2020 / Revised: 14 December 2020 / Accepted: 24 December 2020 / Published: 28 December 2020
(This article belongs to the Special Issue Protective Strategies against Organ Ischemic Injury)
Oxygenated ex situ machine perfusion of donor livers is an alternative for static cold preservation that can be performed at temperatures from 0 °C to 37 °C. Organ metabolism depends on oxygen to produce adenosine triphosphate and temperatures below 37 °C reduce the metabolic rate and oxygen requirements. The transport and delivery of oxygen in machine perfusion are key determinants in preserving organ viability and cellular function. Oxygen delivery is more challenging than carbon dioxide removal, and oxygenation of the perfusion fluid is temperature dependent. The maximal oxygen content of water-based solutions is inversely related to the temperature, while cellular oxygen demand correlates positively with temperature. Machine perfusion above 20 °C will therefore require an oxygen carrier to enable sufficient oxygen delivery to the liver. Human red blood cells are the most physiological oxygen carriers. Alternative artificial oxygen transporters are hemoglobin-based oxygen carriers, perfluorocarbons, and an extracellular oxygen carrier derived from a marine invertebrate. We describe the principles of oxygen transport, delivery, and consumption in machine perfusion for donor livers using different oxygen carrier-based perfusion solutions and we discuss the properties, advantages, and disadvantages of these carriers and their use. View Full-Text
Keywords: machine perfusion; liver; gas transport; artificial oxygen carriers; oxygen; carbon dioxide; temperature machine perfusion; liver; gas transport; artificial oxygen carriers; oxygen; carbon dioxide; temperature
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MDPI and ACS Style

Bodewes, S.B.; van Leeuwen, O.B.; Thorne, A.M.; Lascaris, B.; Ubbink, R.; Lisman, T.; Monbaliu, D.; De Meijer, V.E.; Nijsten, M.W.N.; Porte, R.J. Oxygen Transport during Ex Situ Machine Perfusion of Donor Livers Using Red Blood Cells or Artificial Oxygen Carriers. Int. J. Mol. Sci. 2021, 22, 235. https://doi.org/10.3390/ijms22010235

AMA Style

Bodewes SB, van Leeuwen OB, Thorne AM, Lascaris B, Ubbink R, Lisman T, Monbaliu D, De Meijer VE, Nijsten MWN, Porte RJ. Oxygen Transport during Ex Situ Machine Perfusion of Donor Livers Using Red Blood Cells or Artificial Oxygen Carriers. International Journal of Molecular Sciences. 2021; 22(1):235. https://doi.org/10.3390/ijms22010235

Chicago/Turabian Style

Bodewes, Silke B., Otto B. van Leeuwen, Adam M. Thorne, Bianca Lascaris, Rinse Ubbink, Ton Lisman, Diethard Monbaliu, Vincent E. De Meijer, Maarten W.N. Nijsten, and Robert J. Porte. 2021. "Oxygen Transport during Ex Situ Machine Perfusion of Donor Livers Using Red Blood Cells or Artificial Oxygen Carriers" International Journal of Molecular Sciences 22, no. 1: 235. https://doi.org/10.3390/ijms22010235

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