Advances in hypothermic perfusion

Clavien, Pierre‐Alain; Dutkowski, Philipp

doi:10.1002/lt.24844

Cited by 5 publications

(2 citation statements)

References 44 publications

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“…Besides its reconditioning potential, preservation is one of the most relevant advantages provided by DHOPE. (47) Some authors already hypothesized the possible organizational impact of prolonged preservation of liver grafts (24,48) : to change a recipient or accept a graft discarded after in situ perfusion by other centers prevents the loss of a possible transplantable graft. Our results showed that a prolonged cold preservation time could impact the rate and severity of post-LT complications with a prolonged hospital stay, regardless of donor and graft characteristics.…”

Section: Discussionmentioning

confidence: 99%

The Role of Ex Situ Hypothermic Oxygenated Machine Perfusion and Cold Preservation Time in Extended Criteria Donation After Circulatory Death and Donation After Brain Death

et al. 2021

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Hypothermic oxygenated machine perfusion (HOPE) has the potential to counterbalance the detrimental consequences of cold and warm ischemia time (WIT) in both donation after brain death (DBD) and donation after circulatory death (DCD). Herein we investigated the protective effects of HOPE in extended criteria donor (ECD) DBD and overextended WIT DCD grafts.The present retrospective case series included 50 livers subjected to end-ischemic HOPE or dual DHOPE in 2 liver transplantation (LT) centers from January 2018 to December 2019. All DCD donors were subjected to normothermic regional perfusion before organ procurement. Results are expressed as median (interquartile range [IQR]). In the study period, 21 grafts were derived from overextended WIT DCD donors (total WIT 54 [IQR, 40-60] minutes and 75% classified as futile), whereas 29 were from ECD DBD. A total of 3 biliary complications and 1 case of ischemia-type biliary lesion were diagnosed. The rate of early allograft dysfunction (EAD) was 20%, and those patients had higher Comprehensive Complication Index scores. Through a changing point analysis, cold preservation time >9 hours was associated with prolonged hospital stays (P = 0.02), higher rates of EAD (P = 0.009), and worst post-LT complications (P = 0.02). Logistic regression analyses indicated a significant relationship between cold preservation time and EAD. No differences were shown in terms of the early post-LT results between LTs performed with DCD and DBD. Overall, our data are fully comparable with benchmark criteria in LT. In conclusion, the application of DHOPE obtained satisfactory and promising results using ECD-DBD and overextended DCD grafts. Our findings indicate the need to reduce cold preservation time also in the setting of DHOPE, particularly for grafts showing poor quality.

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Section: Discussionmentioning

confidence: 99%

The Role of Ex Situ Hypothermic Oxygenated Machine Perfusion and Cold Preservation Time in Extended Criteria Donation After Circulatory Death and Donation After Brain Death

et al. 2021

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“…The biliary outcomes were also encouraging; none of the preserved livers required retransplantation for nonanastomotic biliary stricture, as opposed to 5 of 20 livers in the control group. In the largest HMP clinical trial performed, 50 recipients of extended DCD livers achieved superior outcomes compared with nonperfused DCD grafts and perfused DBD grafts [122]. …”

Section: Classification Of Perfusion Techniques Based On Preservationmentioning

confidence: 99%

Organ Preservation into the 2020s: The Era of Dynamic Intervention

Petrenko

Carnevale

Somov

et al. 2019

Transfus Med Hemother

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Organ preservation has been of major importance ever since transplantation developed into a global clinical activity. The relatively simple procedures were developed on a basic comprehension of low-temperature biology as related to organs outside the body. In the past decade, there has been a significant increase in knowledge of the sequelae of effects in preserved organs, and how dynamic intervention by perfusion can be used to mitigate injury and improve the quality of the donated organs. The present review focuses on (1) new information about the cell and molecular events impacting on ischemia/reperfusion injury during organ preservation, (2) strategies which use varied compositions and additives in organ preservation solutions to deal with these, (3) clear definitions of the developing protocols for dynamic organ perfusion preservation, (4) information on how the choice of perfusion solutions can impact on desired attributes of dynamic organ perfusion, and (5) summary and future horizons.

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Principles and current status of abdominal organ preservation for transplantation

Abbas

Friend

2020

Surgery in Practice and Science

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Advances in hypothermic perfusion

Cited by 5 publications

References 44 publications

The Role of Ex Situ Hypothermic Oxygenated Machine Perfusion and Cold Preservation Time in Extended Criteria Donation After Circulatory Death and Donation After Brain Death

The Role of Ex Situ Hypothermic Oxygenated Machine Perfusion and Cold Preservation Time in Extended Criteria Donation After Circulatory Death and Donation After Brain Death

Organ Preservation into the 2020s: The Era of Dynamic Intervention

Principles and current status of abdominal organ preservation for transplantation

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