Long-term outcomes after normothermic machine perfusion in liver transplantation-Experience at a single North American center
Copyright © 2023 American Society of Transplantation & American Society of Transplant Surgeons. Published by Elsevier Inc. All rights reserved..
Normothermic machine perfusion (NMP) has emerged as a valuable tool in the preservation of liver allografts before transplantation. Randomized trials have shown that replacing static cold storage (SCS) with NMP reduces allograft injury and improves graft utilization. The University of Alberta's liver transplant program was one of the early adopters of NMP in North America. Herein, we describe our 7-year experience applying NMP to extend preservation time in liver transplantation using a "back-to-base" approach. From 2015 to 2021, 79 livers were transplanted following NMP, compared with 386 after SCS only. NMP livers were preserved for a median time of minutes compared with minutes in the SCS cohort (P < .0001). Despite this, we observed significantly improved 30-day graft survival (P = .030), although there were no differences in long-term patient survival, major complications, or biliary or vascular complications. We also found that although SCS time was strongly associated with increased graft failure at 1 year in the SCS cohort (P = .006), there was no such association among NMP livers (P = .171). Our experience suggests that NMP can safely extend the total preservation time of liver allografts without increasing complications.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:23 |
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| Enthalten in: |
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons - 23(2023), 7 vom: 01. Juli, Seite 976-986 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Hefler, Joshua [VerfasserIn] |
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| Links: |
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| Themen: |
Graft survival |
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| Anmerkungen: |
Date Completed 04.07.2023 Date Revised 13.07.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.ajt.2023.04.013 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM355906775 |
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| 520 | |a Copyright © 2023 American Society of Transplantation & American Society of Transplant Surgeons. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a Normothermic machine perfusion (NMP) has emerged as a valuable tool in the preservation of liver allografts before transplantation. Randomized trials have shown that replacing static cold storage (SCS) with NMP reduces allograft injury and improves graft utilization. The University of Alberta's liver transplant program was one of the early adopters of NMP in North America. Herein, we describe our 7-year experience applying NMP to extend preservation time in liver transplantation using a "back-to-base" approach. From 2015 to 2021, 79 livers were transplanted following NMP, compared with 386 after SCS only. NMP livers were preserved for a median time of minutes compared with minutes in the SCS cohort (P < .0001). Despite this, we observed significantly improved 30-day graft survival (P = .030), although there were no differences in long-term patient survival, major complications, or biliary or vascular complications. We also found that although SCS time was strongly associated with increased graft failure at 1 year in the SCS cohort (P = .006), there was no such association among NMP livers (P = .171). Our experience suggests that NMP can safely extend the total preservation time of liver allografts without increasing complications | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a graft survival | |
| 650 | 4 | |a liver transplantation | |
| 650 | 4 | |a normothermic machine perfusion | |
| 700 | 1 | |a Leon-Izquierdo, Dayne |e verfasserin |4 aut | |
| 700 | 1 | |a Marfil-Garza, Braulio A |e verfasserin |4 aut | |
| 700 | 1 | |a Meeberg, Glenda |e verfasserin |4 aut | |
| 700 | 1 | |a Verhoeff, Kevin |e verfasserin |4 aut | |
| 700 | 1 | |a Anderson, Blaire |e verfasserin |4 aut | |
| 700 | 1 | |a Dajani, Khaled |e verfasserin |4 aut | |
| 700 | 1 | |a Bigam, David L |e verfasserin |4 aut | |
| 700 | 1 | |a Shapiro, A M James |e verfasserin |4 aut | |
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