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Impact of Portable Normothermic Machine Perfusion for Liver Transplantation From Adult Deceased Donors.
Yamamoto, Takayuki; Atthota, Srilakshmi; Agarwal, Divyansh; Crisalli, Kerry; MacConmara, Malcolm; Nakamura, Tsukasa; Teo, Richard; Dageforde, Leigh Anne; Kimura, Shoko; Elias, Nahel; Yeh, Heidi; Bozorgzadeh, Adel; Kawai, Tatsuo; Markmann, James F.
Afiliación
  • Yamamoto T; Department of Surgery and Center for Transplantation Sciences, Massachusetts General Hospital/Harvard Medical School, Boston, MA.
  • Atthota S; Department of Surgery and Center for Transplantation Sciences, Massachusetts General Hospital/Harvard Medical School, Boston, MA.
  • Agarwal D; Department of Surgery and Center for Transplantation Sciences, Massachusetts General Hospital/Harvard Medical School, Boston, MA.
  • Crisalli K; Department of Surgery and Center for Transplantation Sciences, Massachusetts General Hospital/Harvard Medical School, Boston, MA.
  • MacConmara M; TransMedics OCS, Andover, MA.
  • Nakamura T; Department of Surgery and Center for Transplantation Sciences, Massachusetts General Hospital/Harvard Medical School, Boston, MA.
  • Teo R; Department of Surgery and Center for Transplantation Sciences, Massachusetts General Hospital/Harvard Medical School, Boston, MA.
  • Dageforde LA; Department of Surgery and Center for Transplantation Sciences, Massachusetts General Hospital/Harvard Medical School, Boston, MA.
  • Kimura S; Department of Surgery and Center for Transplantation Sciences, Massachusetts General Hospital/Harvard Medical School, Boston, MA.
  • Elias N; Department of Surgery and Center for Transplantation Sciences, Massachusetts General Hospital/Harvard Medical School, Boston, MA.
  • Yeh H; Department of Surgery and Center for Transplantation Sciences, Massachusetts General Hospital/Harvard Medical School, Boston, MA.
  • Bozorgzadeh A; Department of Surgery and Center for Transplantation Sciences, Massachusetts General Hospital/Harvard Medical School, Boston, MA.
  • Kawai T; Department of Surgery and Center for Transplantation Sciences, Massachusetts General Hospital/Harvard Medical School, Boston, MA.
  • Markmann JF; Department of Surgery and Center for Transplantation Sciences, Massachusetts General Hospital/Harvard Medical School, Boston, MA.
Ann Surg ; 278(5): e922-e929, 2023 Nov 01.
Article en En | MEDLINE | ID: mdl-37581260
OBJECTIVE: To assess how liver allografts preserved using portable normothermic machine perfusion (NMP) compare against those that underwent ischemic cold storage (ICS) in the setting of donation after brain death (DBD) and donation after circulatory death (DCD) liver transplantation (LT). BACKGROUND: Compared with conventional ICS, NMP may offer more homeostatic preservation, permit physiological assessment of organ function, and provide opportunities for graft improvement/modification. We report a single-center US experience of liver NMP. METHODS: A single-center, retrospective analysis of collected data on 541 adult whole LTs from 469 DBD donors [NMP (n = 58) vs ICS (n = 411)] and 72 DCD donors [NMP (n = 52) vs ICS (n = 20)] between January 2016 and December 2022. RESULTS: In DBD LT, male sex [odds ratio (95% CI): 1.83 (1.08-3.09)] and >10% macrosteatosis of the donor liver [1.85 (1.10-3.10)] were statistically significant independent risk factors of early allograft dysfunction (EAD). Donor age >40 years and cold ischemia time >7 hours were independent risk factors of reperfusion syndrome (RPS). One-year, 3-year, and 5-year incidences of ischemic cholangiopathy (IC) did not differ significantly in DBD cases between the NMP and ICS cohorts. In DCD LT, NMP was an independent protective factor against EAD [0.11 (0.03-0.46)] and RPS [0.04 (0.01-0.25)]. The incidence of IC in the DCD cases at 1-year and 3-year time points was significantly lower in the NMP cohort (1.9% compared with 20% in the ICS group). CONCLUSIONS: Compared with conventional ICS, NMP can significantly reduce the incidence of EAD, RPS, and IC after DCD LT.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Risk_factors_studies Idioma: En Revista: Ann Surg Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Risk_factors_studies Idioma: En Revista: Ann Surg Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos