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Mathematical modeling of donor liver cooling during hypothermic perfusion

https://doi.org/10.20340/vmi-rvz.2025.2.ICTM.1

Abstract

Proper cooling of donor liver is critical for transplantation, as it extends organ viability and minimizes tissue damage. Our mathematical model, although simplified, revealed that standard cooling methods do not provide uniformity: cooling rates of different liver regions vary significantly. This creates a risk of temperature gradient within the organ and uneven ischemic tissue damage. The results emphasize the need to improve cooling techniques to ensure more uniform temperature distribution in the donor organ.

Objective. Development of a mathematical model to optimize donor liver cooling and minimize the risk of ischemia-reperfusion injury.

Materials and methods. For modeling the liver cooling process, the Navier-Stokes equation system was used, accounting for porous media and heat transfer parameters. The calculations employed a standard cooling method with coolant delivery through the hepatic artery at constant pressure and temperature. The study was performed using the PHOENICS software package, which provided dynamic data on coolant flow velocity, pressure distribution, temperature, and temperature gradients within the liver over time. The model considers the anatomical features of the liver and the main characteristics of the vascular network.

Results. Numerical modeling showed that liver cooling occurs unevenly. Segments located closer to the coolant inlet cool first, while distant segments reach optimal temperature significantly later. The temperature difference between various segments during cooling reaches critical values, which may lead to heterogeneous ischemic damage. Complete cooling of the organ in the proposed model occurs within 720 seconds, with significant temperature gradients observed between central and peripheral areas of the liver throughout most of the cooling process.

Conclusions. Existing liver cooling methods require optimization to ensure uniform temperature distribution across all segments. A modification of the technique using variable coolant supply pressure and multipoint perfusion is proposed. The resulting mathematical model can be used to develop improved cooling methods for donor organs, which will enhance their preservation, reduce the risk of ischemiareperfusion injury, and improve transplantation outcomes. Further development of the model involves accounting for more detailed anatomical features and physiological parameters of the liver.

About the Authors

A. V. Bukharov
National Research University "MPEI"

Aleksandr V. Bukharov, Dr. Sci. (Tech.), Professor, leading scientist in the field of thermal physics and hydrodynamics of monodisperse flows

 



A. F. Ginevsky
National Research University "MPEI"

Aleksey F. Ginevsky, Cand. Sci. (Tech.), Associate Professor of the Department of Low Temperatures

 



I. S. Seregin
National Research University "MPEI"

Ivan S. Seregin, Engineer

 



B. I. Yaremin
N.V. Sklifosovsky Research Institute of Emergency Medicine; Pirogov Russian National Research Medical University; National Medical Research Center of Oncology named after N.N. Blokhin; Moscow Medical University "Reaviz"
Russian Federation

Boris I. Yaremin, Cand. Sci. (Med.), Docent, surgeon, researcher; Associate Professor of the Department of Transplantology and Artificial Organs, Head of the Department of Surgical Diseases; Head of the Surgical Department for Coordination of Human Organ and/or Tissue Donation 

3, Bolshaya Sukharevskaya Square, Moscow, 129090

1, Ostrovityanova St., Moscow, 117513

23, Kashirskoe shosse, Moscow, 115522

2, Krasnobogatyrskaya st., building 2, Moscow, 107564



E. Yu. Anosova
N.V. Sklifosovsky Research Institute of Emergency Medicine; Pirogov Russian National Research Medical University

Ekaterina Yu. Anosova, Clinical resident of the liver transplantation Center; Assistant Professor, Department of Morphology

3, Bolshaya Sukharevskaya Square, Moscow, 129090

1, Ostrovityanova St., Moscow, 117513



B. I. Kazymov
N.V. Sklifosovsky Research Institute of Emergency Medicine; Pirogov Russian National Research Medical University; National Medical Research Center of Oncology named after N.N. Blokhin; Moscow Medical University "Reaviz"

Bakhtiyar I. Kazymov, Surgeon, researcher at the Liver Transplantation Center, N.V. Sklifosovsky Research Institute of Emergency Medicine; Assistant of the Department of Surgical Diseases

3, Bolshaya Sukharevskaya Square, Moscow, 129090

1, Ostrovityanova St., Moscow, 117513

23, Kashirskoe shosse, Moscow, 115522

2, Krasnobogatyrskaya st., building 2, Moscow, 107564



M. S. Novruzbekov
N.V. Sklifosovsky Research Institute of Emergency Medicine; Pirogov Russian National Research Medical University; National Medical Research Center of Oncology named after N.N. Blokhin; Moscow Medical University "Reaviz"

Murad S. Novruzbekov, Dr. Sci. (Med.), Professor, Scientific Director of the Liver Transplantation Center; Head of the Department of Transplantology and Artificial Organs; Professor of the Department of Surgical Diseases

3, Bolshaya Sukharevskaya Square, Moscow, 129090

1, Ostrovityanova St., Moscow, 117513

23, Kashirskoe shosse, Moscow, 115522

2, Krasnobogatyrskaya st., building 2, Moscow, 107564



References

1. 1 World Health Organization (WHO) (2023) ‘Global Hepatitis Report’. Available at: www.who.int (Accessed: 20 January 2024).

2. 2 European Association for the Study of the Liver (EASL) ‘Liver disease burden in Europe: Epidemiology and challenges’. Journal of Hepatology. 2023;78(5):980-998.

3. 3 Global Observatory on Donation and Transplantation (GODT) (2023) ‘Annual Global Transplant Report’. Available at: www.transplantobservatory.org (Accessed: 20 January 2024).

4. 4 United Network for Organ Sharing (UNOS) (2023) ‘Annual Liver Transplantation Report’. Available at: www.unos.org (Accessed: 20 January 2024).

5. 5 Organ Procurement and Transplantation Network (OPTN) (2023) ‘Liver Transplant Statistics 2023’. Available at: www.optn.transplant.hrsa.gov (Accessed: 20 January 2024).

6. 6 Papalois V.E., Kostopanagiotou G. Organ Donation and Transplantation: An Interdisciplinary Approach. London: Springer. 2016.

7. 7 Kupiec-Weglinski J.W., Busuttil R.W. Ischemia and reperfusion injury in liver transplantation. Transplantation Proceedings. 2015;47(3):1193-1197.

8. 8 Hauet T., Eugene M. A new era in organ preservation. American Journal of Transplantation. 2008;8(1):19-27.

9. 9 Moers C., Smits J.M., Maathuis M.H.J., Treckmann J. Machine perfusion or cold storage in deceased-donor kidney transplantation. The New England Journal of Medicine. 2012;366(8):770-781.

10. 10 Watson C.J.E., Kosmoliaptsis V., Pley C., Randle L.V., Gimson A.E., Brais R., Klinck J.R., Friend P.J. Normothermic perfusion of the isolated liver for preservation and transplantation. American Journal of Transplantation. 2010;10(1):204-214.

11. 11 Van Rijn R., Schurink I.J., de Vries Y., van den Berg A.P., Cerisuelo M.C., Martins P.N., Fondevila C., Perera M.T.P.R., Hessheimer A.J., Heaton N., Putter H. Hypothermic machine perfusion in liver transplantation: A randomized trial. The New England Journal of Medicine. 2017;376(21):1932-1941.

12. 12 Nasralla D., Coussios C.C., Mergental H., Akhtar M.Z., Butler A.J., Ceresa C.D.L., Chiocchia V., Dutton J.J., Garcia-Valdecasas J.C., Heaton N., Hodson L. A randomized trial of normothermic preservation in liver transplantation. Nature. 2018;557(7703):50-56.

13. 13 Weissenbacher A., Vrakas G., Nasralla D., Ceresa C.D. The future of organ perfusion and reconditioning. Transplant International. 2019; 32(6):586-597.

14. 14 Giwa S., Lewis J.K., Alvarez L., Langer R., Roth A.E., Church G.M., Markmann J.F., Sachs D.H., Chandraker A., Wertheim J.A., Rothblatt M., Boyden E.S., Eidbo E. The promise of organ and tissue preservation to transform medicine. Nature Biotechnology. 2017;35(6):530-542.

15. 15 Ding C., Ge J., Lian F., Han X., Li Q. Advances in liver preservation: A review of new strategies and technologies. World Journal of Gastroenterology. 2019;25(2):153-165.

16. 16 Elliott G., Bartlett A., Josephson M., Morris P. Cryopreservation of liver tissues for transplantation: Current perspectives. Journal of Transplantation Science and Technology. 2017;9(3):215-229.

17. 17 Carrel A. Transplantation of Tissues and Organs. New York: Macmillan. 2019.

18. 18 Blagodatskikh A.V. i dr. Ustanovka dlya izmereniya teploprovodnosti tkaney biologicheskikh ob′′yektov. Tez.dokl. kafedry «Vy-chislitel′naya tekhnika» (Izhevsk, 2–6 apr. 1996 g.). Izhevsk : Ekspertiza, 1996:37. (In Russ.).

19. 18 Blagodatskikh A.V. i dr. Metodika izmereniya teplofizicheskikh parametrov tkaney biologicheskikh ob′′yektov. Tez. dokl. ka-fedry «Vychislitel′naya tekhnika» (Izhevsk, 2–6apr. 1996 g.). Izhevsk : Ekspertiza, 1996:36. (In Russ.).

20. 20 Kulikov V.A., Syakterev V.N. System for measuring thermal conductivity of biological tissue. Bulletin of Izhevsk State Technical University. 2012;4(56):116–118. (In Russ.).

21. 21 Official site of company CHAM / Products, 2013. URL: www.cham.co.uk.

22. 22 Bukharov A.V., Martynyuk A.Р., Ginevskiy A.F., Bukharova М.А., Gulyaev V.A. A mathematical model of donor kidney cooling in hypothermic non-perfusion preservation. Sovremennye tehnologii v medicine. 2019;11(2):123–128. https://doi.org/10.17691/stm2019.11.2.18


Review

For citations:


Bukharov A.V., Ginevsky A.F., Seregin I.S., Yaremin B.I., Anosova E.Yu., Kazymov B.I., Novruzbekov M.S. Mathematical modeling of donor liver cooling during hypothermic perfusion. Bulletin of the Medical Institute "REAVIZ" (REHABILITATION, DOCTOR AND HEALTH). 2025;15(2):179-188. (In Russ.) https://doi.org/10.20340/vmi-rvz.2025.2.ICTM.1

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