Prolonged preservation by hypothermic machine perfusion facilitates logistics in liver transplantation: A European observational cohort study

Brueggenwirth, Isabel M. A.; Mueller, Matteo; Lantinga, Veerle A.; Camagni, Stefania; De Carlis, Riccardo; De Carlis, Luciano; Colledan, Michele; Dondossola, Daniele; Drefs, Moritz; Eden, Janina; Ghinolfi, Davide; Koliogiannis, Dionysios; Lurje, Georg; Manzia, Tommaso M.; Monbaliu, Diethard; Muiesan, Paolo; Patrono, Damiano; Pratschke, Johann; Romagnoli, Renato; Rayar, Michel; Roma, Federico; Schlegel, Andrea; Dutkowski, Philipp; Porte, Robert J. und de Meijer, Vincent E. (2022): Prolonged preservation by hypothermic machine perfusion facilitates logistics in liver transplantation: A European observational cohort study. In: American Journal of Transplantation, Bd. 22, Nr. 7: S. 1842-1851

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.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 1600-6135
• Sprache: Englisch