{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T02:19:30Z","timestamp":1762049970608,"version":"build-2065373602"},"reference-count":33,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2022,5,9]],"date-time":"2022-05-09T00:00:00Z","timestamp":1652054400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"START program of the Faculty of Medicine RWTH Aachen","award":["#108\/21"],"award-info":[{"award-number":["#108\/21"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Organ shortage has led to the increasing utilization of livers retrieved from donors after circulatory death (DCD). These pre-damaged organs are susceptible to further warm ischemia and exhibit minimal tolerance for cold storage. The aim was thus to examine the effects of fibrinolysis combined with Venous Systemic Oxygen Persufflation (VSOP) on the preservation of DCD livers in vivo. Livers of male Lewis rats were explanted after 45 min of warm ischemia, cold-stored for 18 h, and transplanted into a recipient animal. Livers were left untreated or underwent either VSOP or fibrinolysis via Streptokinase (SK) or received combined SK and VSOP. Combined treatment exhibited improved microvascular flow at 168 h (p = 0.0009) and elevated microperfusion velocity at 24 h post-transplantation (p = 0.0007). Combination treatment demonstrated increased portal venous flow (PVF) at 3 and 24 h post-transplantation (p = 0.0004, p &lt; 0.0001), although SK and VSOP analogously achieved increases at 24 h (p = 0.0036, p = 0.0051). Enzyme release was decreased for combination treatment (p = 0.0002, p = 0.0223) and lactate dehydrogenase (LDH) measurements were lower at 24 h post-transplantation (p = 0.0287). Further supporting findings have been obtained in terms of serum cytokine levels and in the alterations of endothelial injury markers. The combination treatment of SK + VSOP might provide improved organ integrity and viability and may therefore warrant further investigation as a potential therapeutic approach in the clinical setting of DCD.<\/jats:p>","DOI":"10.3390\/ijms23095272","type":"journal-article","created":{"date-parts":[[2022,5,9]],"date-time":"2022-05-09T21:23:27Z","timestamp":1652131407000},"page":"5272","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Benefits of Fibrinolysis Combined with Venous Systemic Oxygen Persufflation (VSOP) in a Rat Model of Donation after Circulatory Death and Orthotopic Liver Transplantation"],"prefix":"10.3390","volume":"23","author":[{"given":"Nadja","family":"Kr\u00f6ger","sequence":"first","affiliation":[{"name":"Institute for Laboratory Animal Science and Experimental Surgery, Faculty of Medicine, RWTH-Aachen University, Pauwelsstra\u00dfe 30, 52074 Aachen, Germany"},{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937 K\u00f6ln, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0373-3210","authenticated-orcid":false,"given":"Zoltan","family":"Czigany","sequence":"additional","affiliation":[{"name":"Institute for Laboratory Animal Science and Experimental Surgery, Faculty of Medicine, RWTH-Aachen University, Pauwelsstra\u00dfe 30, 52074 Aachen, Germany"},{"name":"Department of Surgery and Transplantation, Faculty of Medicine, University Hospital RWTH-Aachen, 52074 Aachen, Germany"},{"name":"Department of Surgery, Campus Charit\u00e9 Mitte\/Campus Virchow-Klinikum, Charit\u00e9-Universit\u00e4tsmedizin, 13353 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jipin","family":"Jiang","sequence":"additional","affiliation":[{"name":"Institute for Laboratory Animal Science and Experimental Surgery, Faculty of Medicine, RWTH-Aachen University, Pauwelsstra\u00dfe 30, 52074 Aachen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mamdouh","family":"Afify","sequence":"additional","affiliation":[{"name":"Institute for Laboratory Animal Science and Experimental Surgery, Faculty of Medicine, RWTH-Aachen University, Pauwelsstra\u00dfe 30, 52074 Aachen, Germany"},{"name":"Department of Pathology, Faculty of Veterinary Medicine, Cairo University, Giza 12211, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pascal","family":"Paschenda","sequence":"additional","affiliation":[{"name":"Institute for Laboratory Animal Science and Experimental Surgery, Faculty of Medicine, RWTH-Aachen University, Pauwelsstra\u00dfe 30, 52074 Aachen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuyuki","family":"Nagai","sequence":"additional","affiliation":[{"name":"Institute for Laboratory Animal Science and Experimental Surgery, Faculty of Medicine, RWTH-Aachen University, Pauwelsstra\u00dfe 30, 52074 Aachen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7465-5761","authenticated-orcid":false,"given":"Shintaro","family":"Yagi","sequence":"additional","affiliation":[{"name":"Institute for Laboratory Animal Science and Experimental Surgery, Faculty of Medicine, RWTH-Aachen University, Pauwelsstra\u00dfe 30, 52074 Aachen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ren\u00e9 H.","family":"Tolba","sequence":"additional","affiliation":[{"name":"Institute for Laboratory Animal Science and Experimental Surgery, Faculty of Medicine, RWTH-Aachen University, Pauwelsstra\u00dfe 30, 52074 Aachen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,5,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1136\/bmj.332.7538.376","article-title":"Liver Transplantation from Non-Heart Beating Donors","volume":"332","author":"White","year":"2006","journal-title":"BMJ"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1111\/liv.13946","article-title":"Machine Perfusion for Liver Transplantation in the Era of Marginal Organs-New Kids on the Block","volume":"39","author":"Czigany","year":"2019","journal-title":"Liver Int."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1166","DOI":"10.1053\/j.gastro.2019.02.051","article-title":"Evolving Trends in Machine Liver Perfusion: Comments on Clinical End Points and Selection Criteria","volume":"157","author":"Czigany","year":"2019","journal-title":"Gastroenterology"},{"key":"ref_4","first-page":"2913","article-title":"Time Is of the Essence: The Pressing Need for Comprehensive Non-Heart-Beating Cadaveric Donation Policies","volume":"27","author":"Arnold","year":"1995","journal-title":"Transplant. 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