This is a huge step forward in learning how to restore brain function following a sudden cardiac arrest.

Researchers at the Sun Yat-Sen University in China have succeeded in reviving a pig’s brain an hour after blood circulation had stopped, with some functionality sustained for several hours. This achievement, described in the journal EMBO Molecular Medicine, marks a major breakthrough in exploring how to restore brain function following a sudden cardiac arrest, potentially extending the narrow window for resuscitation of humans.

The key to of the experiment was the integration of an undamaged liver into the life support system used to revive the brain. The liver, which filters blood, appears essential in mitigating the effects of ischemia - a dangerous reduction in blood flow that can cause rapid, irreversible damage in the brain within minutes following cardiac arrest.

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Ischemia affecting multiple organs is known to impact brain recovery after cardiac arrest, but the individual contributions of organs remain under investigation.

In recent years, scientists have used pig models to study methods of minimizing brain injury.

The team led by physician Xiaoshun He at the Sun Yat-Sen University turned to studying the liver's role in brain recovery after ischemia.

Using 17 lab-raised Tibetan minipigs, the scientists compared the effects of liver-assisted and non-liver-assisted brain ischemia. One group was subjected to both brain and liver ischemia for 30 minutes, while another group only experienced brain ischemia, and a control group underwent no ischemia. The brains of pigs that avoided liver ischemia showed significantly less damage than those subjected to both brain and liver ischemia.

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In the next stage, the team attempted to revive brains from euthanized pigs using a life support system that included an artificial heart and lungs. For one group, a pig’s liver was integrated, in a technique known as liver-assisted brain normothermic machine perfusion. Brains were connected to the support system 10 minutes after initiation. Without a liver, brain electrical activity appeared briefly but then diminished over time. However, when a liver was included, activity resumed after delays of 30 to 50 minutes post-ischemia and was sustained for up to six hours.

Brains starved of oxygen for 60 minutes showed reduced longevity in activity, lasting only three hours, suggesting a critical timeframe for successful resuscitation with liver support.

These findings underscore the liver’s role in mitigating brain injury post-cardiac arrest and open new research pathways that may improve human survival rates and recovery outcomes.

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