The Use of an Acellular Oxygen Carrier in a Human Liver Model of Normothermic Machine Perfusion

Richard W Laing, Ricky H Bhogal, Lorraine Wallace, Yuri Boteon, Desley A H Neil, Amanda Smith, Barney T F Stephenson, Andrea Schlegel, Stefan G Hübscher, Darius F Mirza, Simon C Afford, Hynek Mergental, Stefan Hubscher

Research output: Contribution to journalArticlepeer-review

55 Citations (Scopus)


BACKGROUND: Normothermic machine perfusion of the liver (NMP-L) is a novel technique that preserves liver grafts under near-physiological conditions while maintaining their normal metabolic activity. This process requires an adequate oxygen supply, typically delivered by packed red blood cells (RBC). We present the first experience using an acellular hemoglobin-based oxygen carrier (HBOC) Hemopure in a human model of NMP-L.

METHODS: Five discarded high-risk human livers were perfused with HBOC-based perfusion fluid and matched to 5 RBC-perfused livers. Perfusion parameters, oxygen extraction, metabolic activity, and histological features were compared during 6 hours of NMP-L. The cytotoxicity of Hemopure was also tested on human hepatic primary cell line cultures using an in vitro model of ischemia reperfusion injury.

RESULTS: The vascular flow parameters and the perfusate lactate clearance were similar in both groups. The HBOC-perfused livers extracted more oxygen than those perfused with RBCs (O2 extraction ratio 13.75 vs 9.43 % ×10 per gram of tissue, P = 0.001). In vitro exposure to Hemopure did not alter intracellular levels of reactive oxygen species, and there was no increase in apoptosis or necrosis observed in any of the tested cell lines. Histological findings were comparable between groups. There was no evidence of histological damage caused by Hemopure.

CONCLUSIONS: Hemopure can be used as an alternative oxygen carrier to packed red cells in NMP-L perfusion fluid.

Original languageEnglish
Pages (from-to)2746-2756
Number of pages11
Issue number11
Publication statusPublished - 1 Nov 2017


  • Adult
  • Aged
  • Apoptosis
  • Blood Substitutes
  • Cells, Cultured
  • Energy Metabolism
  • Female
  • Hemoglobins
  • Hepatectomy
  • Humans
  • Liver
  • Male
  • Middle Aged
  • Necrosis
  • Organ Preservation
  • Oxygen Consumption
  • Perfusion
  • Reactive Oxygen Species
  • Reperfusion Injury
  • Time Factors
  • Tissue Survival
  • Journal Article


Dive into the research topics of 'The Use of an Acellular Oxygen Carrier in a Human Liver Model of Normothermic Machine Perfusion'. Together they form a unique fingerprint.

Cite this