The Groningen hypothermic liver perfusion system for improved preservation in organ transplantation

End-stage liver diseases are nowadays effectively treated by transplantation of
the affected liver. The transplantation procedure includes procurement of the
liver from the donor and subsequently transport of the liver from donor to
receiving patient (Chapter 1). To bridge the timespan of transport between
donor operation and actual implantation of the organ in the receiving patient, the
liver has to be optimally stored and preserved in order to maintain viability of the
organ.
To date, the conventional method of preservation is the Cold Storage (CS)
preservation technique. The CS method implies a single flush of the liver in
situ with an ice-cold preservation solution to wash-out remaining blood and
immediately cool the organ. Subsequently, the liver is stored in a plastic bag
containing cold preservation solution and transported in a cooling box filled with
melting ice to maintain a lowered metabolism during hypothermia (0-4±C). The
University of Wisconsin cold storage (UW-CS) solution is nowadays the golden
standard in preservation solutions. Although CS preservation shows good results in
preserving livers from brain-dead donors, who have an intact circulation, expansion
of the donor pool with an important potential group of non-heart-beating donors
(NHBDs), after cardiac arrest, requires improved preservation techniques.
Hypothermic machine perfusion (HMP) is a dynamic preservation method that
actively perfuses the liver. With HMP a continuous supply of oxygen and removal
of waste products is obtained which improves preservation outcome. Especially
marginal, older and NHB donor livers will benefit from this improved quality.
The aim of this thesis was to develop a hypothermic machine perfusion system
which is able to optimally preserve donor livers.

	Title and contents
	Chapter 1
	Chapter 2
	Chapter 3
	Chapter 4
	Chapter 5
	Chapter 6
	Chapter 7
	Chapter 8
	Chapter 9
	Summary
	Samenvatting
	Dankwoord
	Curriculum Vitae and Publications
	Complete thesis

Meer informatie in de catalogus
Meer informatie in Picarta

Afdrukken op bestelling.