Determination of Minimal Hemoglobin Level Necessary for Normothermic Porcine Ex situ Liver Perfusion

Background In current studies of ex situ liver perfusion there exists considerable variability in perfusate composition, including the type of oxygen carrier. Herein we aim to clarify the minimal hemoglobin level necessary during normothermic porcine ex situ liver perfusion. Methods Livers procured from 35- 45 Kg domestic pigs were connected to our experimental ex situ circuit (n=10). In the treatment group, perfusate was sequentially diluted hourly to predetermined hemoglobin levels. At the end of each hemoglobin dilution, perfusate samples were analyzed for liver transaminases, lactate dehydrogenase, total bilirubin, and lactate levels. Liver oxygen consumption was measured. In the control group, livers were perfused continually for a duration of 24 hours at target hemoglobin levels of 30 and 20 g/L. Results Rising liver transaminases, significantly higher lactate (p

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