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Outcomes of normothermic machine perfusion of liver grafts in repeat liver transplantation (NAPLES initiative).

Authors :
Hann A
Lembach H
Nutu A
Dassanayake B
Tillakaratne S
McKay SC
Boteon APCS
Boteon YL
Mergental H
Murphy N
Bangash MN
Neil DAH
Issac JL
Javed N
Faulkner T
Bennet D
Moore R
Vasanth S
Subash G
Cuell J
Rao R
Cilliers H
Russel S
Haydon G
Mutimer D
Roberts KJ
Mirza DF
Ferguson J
Bartlett D
Isaac JR
Rajoriya N
Armstrong MJ
Hartog H
Perera MTPR
Source :
The British journal of surgery [Br J Surg] 2022 Mar 15; Vol. 109 (4), pp. 372-380.
Publication Year :
2022

Abstract

Background: Retransplantation candidates are disadvantaged owing to lack of good-quality liver grafts. Strategies that can facilitate transplantation of suboptimal grafts into retransplant candidates require investigation. The aim was to determine whether late liver retransplantation can be performed safely with suboptimal grafts, following normothermic machine perfusion.<br />Methods: A prospectively enrolled group of patients who required liver retransplantation received a suboptimal graft preserved via normothermic machine perfusion. This group was compared with both historical and contemporaneous cohorts of patient who received grafts preserved by cold storage. The primary outcome was 6-month graft and patient survival.<br />Results: The normothermic machine perfusion group comprised 26 patients. The historical (cold storage 1) and contemporaneous (cold storage 2) groups comprised 31 and 25 patients respectively. The 6-month graft survival rate did not differ between groups (cold storage 1, 27 of 31, cold storage 2, 22 of 25; normothermic machine perfusion, 22 of 26; P = 0.934). This was despite the normothermic machine perfusion group having significantly more steatotic grafts (8 of 31, 7 of 25, and 14 of 26 respectively; P = 0.006) and grafts previously declined by at least one other transplant centre (5 of 31, 9 of 25, and 21 of 26; P < 0.001).<br />Conclusion: In liver retransplantation, normothermic machine perfusion can safely expand graft options without compromising short-term outcomes.<br /> (© The Author(s) 2022. Published by Oxford University Press on behalf of BJS Society Ltd. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Details

Language :
English
ISSN :
1365-2168
Volume :
109
Issue :
4
Database :
MEDLINE
Journal :
The British journal of surgery
Publication Type :
Academic Journal
Accession number :
35170730
Full Text :
https://doi.org/10.1093/bjs/znab475