Proceeding of Veterinary and Animal Science Days 2017, 6th- 8th June, Milan, Italy 

HAF © 2013 

Vol. IV, No. 1s   ISSN: 2283-3927 

   

 

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Keywords 

Normothermic extracorporeal 

perfusion, Porcine, Liver  

 

CORRESPONDING AUTHOR 

Matteo Ghiringhelli 

matteo.ghiringhelli@unimi.it 

 

JOURNAL HOME PAGE 

riviste.unimi.it/index.php/haf 

Isolated slaughterhouse liver as model for 

normothermic perfusion after warm and cold 

ischemia: single case report 

Matteo Ghiringhelli1*, Stefano Brizzola1, Filippo Consolo3,  

Alessia Di Giancamillo1, Marco Trovatelli1, Piera A. Martino2,  

Camilla Mocchi1, Angelica Stranieri2, Tiziana Vitiello2, Eleonora Fusi1,  

Valentino Bontempo1, Fabio Acocella1 

 

 

1University of Milan, Department of Health, Animal Science and Food Safety, Italy 

2University of Milan, Department of Veterinary Medicine, Italy 

3Politecnico di Milano, Dipartimento di Elettronica, Informazione e Bioingegneria, Italy 

 

 

 

Abstract 

Liver transplantation is an ultimate procedure in patients suffering end-stage liver diseases. In these 

last years the donation after cardiac death (DCD) has increased the pool of potential liver donors. 

Different studies and procedures are involved in the prevention of the main ischemic problems during 

the reconditioning and resuscitation of the marginal livers. Normothermic extracorporeal liver 

perfusion (NELP) avoids prolonged cold storage damage that is the main cause of steatosis and biliary 

tract ischemia in transplanted patiens. Different porcine models have been studied and developed to 

understand the ischemia mechanism and to select the better technique for NELP (Bellomo et al., 2012). 

We conducted our study using a DCD pig liver model collected from slaughterhouse (Grosse-Siestrup 

et al., 2002). Using extracorporeal membrane oxygenation, 2000 ml of total fluid containing 

autologous blood, lidocaine, heparin, antibiotics, glucose 10 % solution and flunixin, the NELP was 

achieved (Guibert et al., 2011). The liver was perfused over 7 hours after 48 hours of cold storage (4C°), 

using Eurocollins solution. During the liver withdrawal in the slaughterhouse 20 minutes were waited 

to simulate the warm ischemia (WI) time. Histological samples, swab for bacterial grow, blood sample 

from venous drainage line, temperature and pulse oximetry saturation were collected to assess the 

liver viability and function. Liver function, reflected by urea, albumin, total cholesterol, total bilirubin 

was seen during NELP. Biochemical and microscopic assessment and an improved oxygen uptake 

revealed minimal injury sustained during perfusion. These analyses revealed stable metabolism 

throughout perfusion identifying a cycles 2 hours length, coinciding with recovery of oxygen uptake 

rates to fresh liver, as described in literature. In summary the preliminary established model of isolated 

hemoperfused slatherhouse liver reveals the important role of the relation between cold storage and 

normothermic perfusion. Moreover this preliminary study justifies further investigation of the 

optimization of the treatment protocols and perfusion media. 

http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en


Proceeding of Veterinary and Animal Science Days 2017, 6th- 8th June, Milan, Italy 

HAF © 2013 

Vol. IV, No. 1s   ISSN: 2283-3927 

 

 

 

 

 

 

 

 

 

 

 
 

 
Fig.1: Results obtained during normothermic preservation. (a) Haematoxylin-eosin-stained liver histology, X 4 
magnification. Biopsies taken after 7 hours of perfusion. (b) Graph displaying 

 

 

References 

Bellomo, R., Suzuki, S., Marino, B., Starkey, GK., Chambers, B., Fink, M.A., Wang, B.Z., Houston S., Eastwood, G., 
Calzavacca, P., Glassford, N., Skene, A., Jones, D.A., Jones, R., 2012. Normothermic extracorporeal perfusion of 
isolated porcine liver after warm ischaemia: a preliminary report. Crit Care Resusc. 14(3), 173-6. 

Guibert, E.E., Petrenko, A.Y., Balaban, C.L., Somov, A.Y., Rodriguez, J.V., Fuller, B.J., 2011. Organ Preservation: 
Current Concepts and New Strategies for the Next Decade. Transfus Med Hemother. 38(2), 125-142. 

Grosse-Siestrup, C., Pfeffer, J., Unger, V., Nagel, S., Witt, C., Fischer, A., Groneberg, D.A., 2002. Isolated 
hemoperfused slaughterhouse livers as a valid model to study hepatotoxicity. Toxicol Pathol. 30(6), 749-54. 

http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en