Eight Years of Extracorporeal Membrane Oxygenation in Liver Transplantation: Our Experience

Torres, Maria Angeles Herrero; Bastante, Mireia Domniguez; Raya, A. Molina; Herrera, María Trinidad Villegas; Massare, A. Becerra; Jiménez, Antonio Palomeque; Gómez, Esther Brea; Carroll, Natalia Zambudio; Moral, Jesús María Villar del

doi:10.1016/j.transproceed.2019.11.050

Cited by 6 publications

(2 citation statements)

References 10 publications

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“…After that, Herrero Torres et al 59 described 10 uDCD livers transplanted after NRP at Granada Liver Transplant Center. They reported only one case of ITBL at a median follow‐up of 67 months.…”

Section: Methodsmentioning

confidence: 99%

Normothermic regional perfusion in liver transplantation from donation after cardiocirculatory death: Technical, biochemical, and regulatory aspects and review of literature

et al. 2022

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Background Organs from donation after circulatory death (DCD) are increasingly used for liver transplantation, due to the persisting organ shortage and waiting list mortality. However, the use of DCD grafts is still limited by the inferior graft survival rate and the increased risk of primary non‐function and biliary complications when compared to brain death donors’ grafts. Methods Abdominal normothermic regional perfusion with extracorporeal membrane oxygenation (ECMO) is an in situ preservation strategy. which may mitigate ischemia–reperfusion injuries. and has been proposed to restore blood perfusion after the determination of death thus optimizing liver function before implantation. Results In this systematic review, we highlighted the clinical evidence supporting the use of normothermic regional perfusion in DCD liver underlying the pathophysiological mechanisms, and technical, logistic, and regulatory aspects. Conclusions Despite the lack of properly designed, prospective, randomized trials, the current available data suggest beneficial effects of normothermic regional perfusion on clinical outcomes after liver transplantation.

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Section: Methodsmentioning

confidence: 99%

Normothermic regional perfusion in liver transplantation from donation after cardiocirculatory death: Technical, biochemical, and regulatory aspects and review of literature

et al. 2022

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“…Previous studies assessing the use of ECMO to improve donor utilization have largely focused on ECMO as a strategy to stabilize donors specifically for the purpose of organ donation. [2][3][4][5][6] The few studies assessing transplantation patterns and outcomes when using organs from ECMO-supported donors who were cannulated for non-organ donation purposes have shown reasonable outcomes to promote their use in select settings. [7][8][9][10] These studies, however, have been limited by small sample sizes, which limit the extent of their analyses.…”

Section: Introductionmentioning

confidence: 99%

Extracorporeal membrane oxygenation for cardiopulmonary failure in organ donation: Assessing liver transplant outcomes

Altshuler

Preston

Pace

et al. 2023

Liver Transplantation

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Liver transplantation continues to face significant organ shortages and efficient utilization of marginal donors is paramount. This study evaluates the practice patterns and outcomes in liver transplantation when utilizing allografts from marginal donors who required extracorporeal membrane oxygenation (ECMO) support. We performed a retrospective review of the Gift of Life (PA, NJ, DE) organ-procuring organization database for transplants performed using donors supported on ECMO for nondonation purposes. These were cross-referenced to the transplant recipients within the Organ Procurement and Transplantation Network database, and the outcomes of liver transplants using donors on ECMO support were compared with those not requiring ECMO. Organ use and nonuse patterns were then evaluated in ECMO-supported donors, identifying the factors associated with nonuse compared with the factors associated with graft failure. Thirty-nine of the 84 ECMO-supported donors contributing at least one intra-abdominal organ for transplant donated a liver. Graft survival and patient survival up to 5 years were comparable between transplants from ECMO and non-ECMO-supported donors, and no cases of primary nonfunction were seen in the ECMO group. ECMO support was not associated with 1-year graft failure on regression modeling. Additional regression analyses within the ECMO donor population identified bacteremia (HR: 19.81) and elevated total bilirubin at donation (HR: 2.44) as predictive of post-transplant graft failure. Livers from donors supported on ECMO before donation appear safe to use in select transplant settings. Better understanding of the impact of predonation ECMO on liver allograft function will help guide the optimal use of these scarcely used donors.

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Cardiopulmonary bypass in noncardiac thoracic surgery

Sareyyüpoğlu

Ahmed

Thomas

2023

Cardiopulmonary Bypass

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Eight Years of Extracorporeal Membrane Oxygenation in Liver Transplantation: Our Experience

Cited by 6 publications

References 10 publications

Normothermic regional perfusion in liver transplantation from donation after cardiocirculatory death: Technical, biochemical, and regulatory aspects and review of literature

Normothermic regional perfusion in liver transplantation from donation after cardiocirculatory death: Technical, biochemical, and regulatory aspects and review of literature

Extracorporeal membrane oxygenation for cardiopulmonary failure in organ donation: Assessing liver transplant outcomes

Cardiopulmonary bypass in noncardiac thoracic surgery

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