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Ringerfundin solution

Manufactured by B. Braun
Sourced in Germany

Ringerfundin solution is a sterile, isotonic solution designed for intravenous administration. It contains a balanced electrolyte composition to help maintain fluid and electrolyte balance in the body.

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4 protocols using ringerfundin solution

1

Anesthesia and Instrumentation for Porcine Model

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Anesthesia and instrumentation protocols were similar to those previously described (Jarkovska et al., 2016 (link)). Anesthesia was induced with intramuscular (IM) tiletamine (2.2 mg/kg), zolazepam (2.2 mg/kg), and xylazine (2.2 mg/kg), together with intravenous (IV) propofol 2% (1–2 mg/kg) and maintained with continuous IV propofol (1–4 mg/kg/h) and fentanyl (5–10 μg/kg/h). Animals were mechanically ventilated (FiO2 0.3, PEEP 8 cm H2O, tidal volume 10 ml/kg, respiratory rate adjusted to maintain end/tidal pCO2 between 4 and 5 kPa), and muscle paralysis was achieved with IV rocuronium (4 mg for induction, 0.2–0.4 mg/kg/h for maintenance). Ringerfundin solution (B. Braun Melsungen AG, Melsungen, Germany) was infused as maintenance fluid (7 ml/kg/h) and normoglycemia (arterial blood glucose level 4.5–7 mmol/L) was maintained using 10% glucose infusion (1–4 ml/kg/h).
All pigs were instrumented with a femoral artery catheter, triple lumen central venous catheter, and pulmonary artery catheter. Silicone drains directed into the anatomical spaces of Morison and Douglas were used for fecal inoculation.
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2

Procurement and Preparation of Declined Liver Grafts

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Ten human livers were obtained for research after being declined for transplantation nationwide and after consent was obtained from the next of kin. The local ethics committee of the Canton of Zurich approved the study protocol (2017-000412). The declined livers were procured in a standardised technique using IGL-1 for cooling and preservation. Some DCD (donation after circulatory death) livers were declined after initial hypothermic oxygenated liver machine perfusion (HOPE) for clinical purpose as stated in Supplementary Table 1 (40 (link)). During setup of the perfusion machine, the livers were prepared on the back table including removal of the gall bladder and cannulation of the hepatic artery (HA), portal vein (PV), vena cava (VC) and bile duct. Shortly before start of liver perfusion, the preservation solution was flushed out with 2 liters of cold (4°C) Ringerfundin solution (B. Braun Melsungen AG) through portal vein (1.5 liter) and hepatic artery (0.5 liter).
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3

Anesthesia and Surgical Procedures in Large Animal Model

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The protocols were described previously in detail [10 (link)]. In short, i.m. tiletamine (2.2 mg/kg), zolazepam (2.2 mg/kg) and xylazine (2.2 mg/kg) together with i.v. propofol 2% (1–4 mg/kg) and fentanyl (5–10 µg/kg/h) were used for anesthesia induction and maintenance. Mechanical ventilation (FiO2 0.3, PEEP 8 cm H2O, tidal volume 10 mL/kg) was adjusted to maintain end/tidal pCO2 between 4 and 5 kPa. For muscle paralysis, i.v. rocuronium (4 mg for induction, 0.2–0.4 mg/kg/h for maintenance) was administered. A Ringerfundin solution (B. Braun Melsungen AG, Melsungen, Germany, 7 mL/kg/h) and 10% glucose infusion (1–4 mL/kg/h) were infused to maintain normovolemia and normoglycemia. The femoral artery, pulmonary artery and triple lumen central venous catheters were used for hemodynamic monitoring and blood sampling. Ultrasound flowprobe (Transonic Systems, Ithaca, NY) around the left renal artery was used for monitoring renal blood flow. Feces were inoculated through silicone drains into Morison and Douglas anatomical spaces.
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4

Procurement and Preparation of Declined Livers

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Ten human livers were obtained for research after being declined for transplantation nationwide and after consent was obtained from the next of kin. The local ethics committee of the Canton of Zurich approved the study protocol (2017-000412). The declined livers were procured in a standardized technique using IGL-1 for cooling and preservation. Some livers from donations after circulatory death were declined after initial hypothermic oxygenated liver machine perfusion for clinical purpose28 (link) (Supplementary Table 1). During setup of the perfusion machine, the livers were prepared on the back table including removal of the gall bladder and cannulation of the hepatic artery, portal vein, vena cava and bile duct. Shortly before the start of liver perfusion, the preservation solution was flushed out with 2 l of cold (4 °C) Ringerfundin solution (B. Braun Melsungen) through the portal vein (1.5 l) and hepatic artery (0.5 l).
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