A randomized trial of normothermic preservation in liver transplantation

Liver transplantation is a highly successful treatment, but is severely limited by the shortage in donor organs. However, many potential donor organs cannot be used; this is because sub-optimal livers do not tolerate conventional cold storage and there is no reliable way to assess organ viability pr...

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Những tác giả chính: Nasralla, D, Coussios, C, Mergental, H, Akhtar, M, Butler, A, Ceresa, C, Chiocchia, V, Dutton, S, García-Valdecasas, J, Heaton, N, Imber, C, Jassem, W, Jochmans, I, Karani, J, Knight, S, Kocabayoglu, P, Malagò, M, Mirza, D, Morris, P, Pallan, A, Paul, A, Pavel, M, Perera, T, Pirenne, J, Ravikumar, R, Russell, L, Upponi, S, Watson, C, Weissenbacher, A, Ploeg, R, Friend, P
Định dạng: Journal article
Được phát hành: Springer Nature 2018
Miêu tả
Tóm tắt:Liver transplantation is a highly successful treatment, but is severely limited by the shortage in donor organs. However, many potential donor organs cannot be used; this is because sub-optimal livers do not tolerate conventional cold storage and there is no reliable way to assess organ viability preoperatively. Normothermic machine perfusion maintains the liver in a physiological state, avoids cooling and allows recovery and functional testing. Here we show that, in a randomized trial with 220 liver transplantations, compared to conventional static cold storage, normothermic preservation is associated with a 50% lower level of graft injury, measured by hepatocellular enzyme release, despite a 50% lower rate of organ discard and a 54% longer mean preservation time. There was no significant difference in bile duct complications, graft survival or survival of the patient. If translated to clinical practice, these results would have a major impact on liver transplant outcomes and waiting list mortality.