A proof of concept study on real-time LiMAx CYP1A2 liver function assessment of donor grafts during normothermic machine perfusion

Ivo J. Schurink, Jubi E. de Haan, Jorke Willemse, Matteo Mueller, Michael Doukas, Henk Roest, Femke H.C. de Goeij, Wojciech G. Polak, Jan N.M. Ijzermans, Philipp Dutkowski, Luc J.W. van der Laan, Jeroen de Jonge*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

No single reliable parameter exists to assess liver graft function of extended criteria donors during ex-vivo normothermic machine perfusion (NMP). The liver maximum capacity (LiMAx) test is a clinically validated cytochromal breath test, measuring liver function based on 13CO2 production. As an innovative concept, we aimed to integrate the LiMAx breath test with NMP to assess organ function. Eleven human livers were perfused using NMP. After one hour of stabilization, LiMAx testing was performed. Injury markers (ALT, AST, miR-122, FMN, and Suzuki-score) and lactate clearance were measured and related to LiMAx values. LiMAx values ranged between 111 and 1838 µg/kg/h, and performing consecutive LiMAx tests during longer NMP was feasible. No correlation was found between LiMAx value and miR-122 and FMN levels in the perfusate. However, a significant inverse correlation was found between LiMAx value and histological injury (Suzuki-score, R = − 0.874, P < 0.001), AST (R = − 0.812, P = 0.004) and ALT (R = − 0.687, P = 0.028). Furthermore, a significant correlation was found with lactate clearance (R = 0.683, P = 0.043). We demonstrate, as proof of principle, that liver function during NMP can be quantified using the LiMAx test, illustrating a positive correlation with traditional injury markers. This new breath-test application separates livers with adequate cytochromal liver function from inadequate ones and may support decision-making in the safe utilization of extended criteria donor grafts.

Original languageEnglish
Article number23444
JournalScientific Reports
Volume11
Issue number1
DOIs
Publication statusPublished - 6 Dec 2021

Bibliographical note

Funding Information:
This research was financially supported by an unrestricted grant from the Dira I Foundation.

Publisher Copyright:
© 2021, The Author(s).

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