Advances in Machine Perfusion Graft Viability Assessment in Kidney, Liver, Pancreas, Lung, and Heart Transplant

Balfoussia, Danai; Yerrakalva, Dharani; Hamaoui, Karim; Papalois,

doi:10.6002/ect.2011.0167

Cited by 41 publications

(31 citation statements)

References 108 publications

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“…Since the organ is metabolically active, its quality can be evaluated by vascular flow parameters, injury markers (i.e., transaminases), and functional indicators such as bile production and metabolic activity [22,23]. By assessing graft injury and metabolic function during organ perfusion, transplant physicians and surgeons can accept or decline liver grafts based on data, instead of historical information and macroscopic appearance.…”

Section: Principles Of Normothermic Liver Perfusionmentioning

confidence: 99%

Early Clinical Results Using Normothermic Machine Liver Preservation

et al. 2015

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The ongoing shortage of donor organs for liver transplantation results in high mortality rates for those on the waiting list. This has triggered considerable interest in the use of marginal liver grafts to increase the donor pool. Unfortunately, marginal grafts poorly tolerate preservation by cold storage (CS), resulting in an increased risk of liver injury and poor graft function after transplantation. Better preservation techniques are needed to fully utilize marginal grafts and to expand the number of organ donors. Animal studies have demonstrated normothermic ex vivo liver perfusion to be superior to conventional CS. Recently, the first clinical trial of normothermic ex vivo liver perfusion was completed with promising results. Similarly, in situ recirculation after cardiac arrest as the initial preservation method before organ procurement has proven to be a valuable technique to make more liver grafts available for transplantation. Though technically more complex and economically more expensive, normothermic liver perfusion is a promising and innovative technique that is able to positively impact current transplant practice and outcomes.

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Section: Principles Of Normothermic Liver Perfusionmentioning

confidence: 99%

Early Clinical Results Using Normothermic Machine Liver Preservation

et al. 2015

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“…There are also several groups using perfusion systems in marginal organs that allow a continuous evaluation of organ function. 77 These systems are very similar to perfusion bioreators, and the conclusions obtained by their experience might be translated to bioengineered organs to determine their readiness for transplantation. These perfusion machines also allow the quantification of viability markers.…”

Section: Duration Of Bioreactor Pre-conditioningmentioning

confidence: 99%

Liver bioengineering

et al. 2014

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“…This continuous perfusion allows better preservation, oxygenation and removal of metabolites [81] . Another advantage is the possibility to monitor the performance of the graft and to provide adjuvant substances [81,82] . PM can be divided into 3 groups based on the temperature of preservation: Hypothermic (HMP) at 4 ℃; normothermic (NMP) at 37 ℃, and subnormothermic (SNMP) at 20 ℃-25 ℃.…”

Section: Machine Perfusion and Machine Preservationmentioning

confidence: 99%

“…PM can be divided into 3 groups based on the temperature of preservation: Hypothermic (HMP) at 4 ℃; normothermic (NMP) at 37 ℃, and subnormothermic (SNMP) at 20 ℃-25 ℃. Different flow regimes and pressures (pulsatile vs unpulsatile), single (artery) vs dual perfusion (artery and portal vein), oxygenated vs nonoxygenated [82] . The HMP, by lowering the metabolism but providing metabolic substrates, is reported to protect grafts from ischemic insults related to reperfusion [83] .…”

Section: Machine Perfusion and Machine Preservationmentioning

confidence: 99%

Strategies to optimize the use of marginal donors in liver transplantation

Pezzati

Ghinolfi

Simone

et al. 2015

WJH

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Liver transplantation is the treatment of choice for end stage liver disease, but availability of liver grafts is still the main limitation to its wider use. Extended criteria donors (ECD) are considered not ideal for several reasons but their use has dramatically grown in the last decades in order to augment the donor liver pool. Due to improvement in surgical and medical strategies, results using grafts from these donors have become acceptable in terms of survival and complications; nevertheless a big debate still exists regarding their selection, discharge criteria and allocation policies. Many studies analyzed the use of these grafts from many points of view producing different or contradictory results so that accepted guidelines do not exist and the use of these grafts is still related to non-standardized policies changing from center to center. The aim of this review is to analyze every step of the donationtransplantation process emphasizing all those strategies, both clinical and experimental, that can optimize results using ECD.

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Advances in Machine Perfusion Graft Viability Assessment in Kidney, Liver, Pancreas, Lung, and Heart Transplant

Cited by 41 publications

References 108 publications

Early Clinical Results Using Normothermic Machine Liver Preservation

Early Clinical Results Using Normothermic Machine Liver Preservation

Liver bioengineering

Strategies to optimize the use of marginal donors in liver transplantation

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