1. Prolonged preservation by hypothermic machine perfusion facilitates logistics in liver transplantation
- Author
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Isabel M.A. Brüggenwirth, Matteo Mueller, Veerle A. Lantinga, Stefania Camagni, Riccardo De Carlis, Luciano De Carlis, Michele Colledan, Daniele Dondossola, Moritz Drefs, Janina Eden, Davide Ghinolfi, Dionysios Koliogiannis, Georg Lurje, Tommaso M. Manzia, Diethard Monbaliu, Paolo Muiesan, Damiano Patrono, Johann Pratschke, Renato Romagnoli, Michel Rayar, Federico Roma, Andrea Schlegel, Philipp Dutkowski, Robert J. Porte, Vincent E. de Meijer, Brüggenwirth, I, Mueller, M, Lantinga, V, Camagni, S, De Carlis, R, De Carlis, L, Colledan, M, Dondossola, D, Drefs, M, Eden, J, Ghinolfi, D, Koliogiannis, D, Lurje, G, Manzia, T, Monbaliu, D, Muiesan, P, Patrono, D, Pratschke, J, Romagnoli, R, Rayar, M, Roma, F, Schlegel, A, Dutkowski, P, Porte, R, de Meijer, V, Groningen Institute for Organ Transplantation (GIOT), Center for Liver, Digestive and Metabolic Diseases (CLDM), and Faculteit Medische Wetenschappen/UMCG
- Subjects
liver allograft function ,liver allograft function/dysfunction ,graft survival ,organ procurement and allocation ,Hypothermia ,GUIDELINES ,clinical research/practice ,Cohort Studies ,Immunology and Allergy ,Humans ,Pharmacology (medical) ,solid organ transplantation ,Transplantation ,Science & Technology ,dysfunction ,liver transplantation ,organ perfusion and preservation ,DEATH ,Organ Preservation ,practice ,Liver Transplantation ,Settore MED/18 ,Perfusion ,ischemia reperfusion injury (IRI) ,liver transplantation/hepatology ,organ acceptance ,DEFINITION ,Liver ,clinical research ,hepatology ,Surgery ,DONATION ,Life Sciences & Biomedicine ,STORAGE - Abstract
A short period (1-2 h) of hypothermic oxygenated machine perfusion (HOPE) after static cold storage is safe and reduces ischemia-reperfusion injury-related complications after liver transplantation. Machine perfusion time is occasionally prolonged for logistical reasons, but it is unknown if prolonged HOPE is safe and compromises outcomes. We conducted a multicenter, observational cohort study of patients transplanted with a liver preserved by prolonged (≥4 h) HOPE. Postoperative biochemistry, complications, and survival were evaluated. The cohort included 93 recipients from 12 European transplant centers between 2014-2021. The most common reason to prolong HOPE was the lack of an available operating room to start the transplant procedure. Grafts underwent HOPE for a median (range) of 4:42 h (4:00-8:35 h) with a total preservation time of 10:50 h (5:50-20:50 h). Postoperative peak ALT was 675 IU/L (interquartile range 419-1378 IU/L). The incidence of postoperative complications was low, and 1-year graft and patient survival were 94% and 88%, respectively. To conclude, good outcomes are achieved after transplantation of donor livers preserved with prolonged (median 4:42 h) HOPE, leading to a total preservation time of almost 21 h. These results suggest that simple, end-ischemic HOPE may be utilized for safe extension of the preservation time to ease transplantation logistics. ispartof: AMERICAN JOURNAL OF TRANSPLANTATION vol:22 issue:7 pages:1842-1851 ispartof: location:United States status: published
- Published
- 2022