How to Preserve Liver Grafts From Circulatory Death With Long Warm Ischemia? A Retrospective Italian Cohort Study With Normothermic Regional Perfusion and Hypothermic Oxygenated Perfusion

Carlis, Riccardo De; Schlegel, Andrea; Frassoni, Samuele; Olivieri, Tiziana; Ravaioli, Matteo; Camagni, Stefania; Patrono, Damiano; Bassi, Daniela; Pagano, Duilio; Sandro, Stefano Di; Lauterio, Andrea; Bagnardi, Vincenzo; Gruttadauria, Salvatore; Cillo, U.; Romagnoli, Renato; Colledan, M.; Cescon, Matteo; Benedetto, Fabrizio Di; Muiesan, Paolo; Carlis, Luciano De

doi:10.1097/tp.0000000000003595

Cited by 72 publications

(120 citation statements)

References 38 publications

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“…Because of these strict criteria, a number of centres could not contribute cases to the benchmark cohort (Italy, Spain, France, and Switzerland routinely use organ perfusion technology; Germany, Portugal, Australia, New Zealand, and Austria have none or limited experience with DCD) [33][34][35][36].…”

Section: Discussionmentioning

confidence: 99%

A multicentre outcome analysis to define global benchmarks for donation after circulatory death liver transplantation

Schlegel

Reeven

Croome

et al. 2022

Journal of Hepatology

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Section: Discussionmentioning

confidence: 99%

A multicentre outcome analysis to define global benchmarks for donation after circulatory death liver transplantation

Schlegel

Reeven

Croome

et al. 2022

Journal of Hepatology

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“…Indeed, kidneys might benefit from improved preservation after NRP, as PNF (in uDCD) and delayed graft function rates in DCD remain high [13, 17]. Most livers have also been cold stored [2], though the Italian experience includes the use of oxygenated hypothermic perfusion [18]. Ex situ perfusion might allow better uDCD liver selection, given high PNF rates after NRP with static cold storage.…”

Section: Recommendations On the Use Of Nrp In Dcdmentioning

confidence: 99%

Consensus statement on normothermic regional perfusion in donation after circulatory death: Report from the European Society for Organ Transplantation’s Transplant Learning Journey

et al. 2021

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Summary Normothermic regional perfusion (NRP) in donation after circulatory death (DCD) is a safe alternative to in situ cooling and rapid procurement. An increasing number of countries and centres are performing NRP, a technically and logistically challenging procedure. This consensus document provides evidence‐based recommendations on the use of NRP in uncontrolled and controlled DCDs. It also offers minimal ethical, logistical and technical requirements that form the foundation of a safe and effective NRP programme. The present article is based on evidence and opinions formulated by a panel of European experts of Workstream 04 of the Transplantation Learning Journey project, which is part of the European Society for Organ Transplantation.

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“…NMP can protect the organ from further ATP depletion and the accumulation of metabolic products during cold ischemia (2). NMP or NRP with D-HOPE for DCD grafts with subsequent transplantation are becoming routine practice in some experienced transplant centers (21)(22)(23). Since oxidative tissue injury and activation of the inflammation response during NMP has been demonstrated (2), the ER stress pathway and unfolded protein response might participate in reperfusion and NMP of the DCD liver graft.…”

Section: Discussionmentioning

confidence: 99%

Pharmacological Activating Transcription Factor 6 Activation Is Beneficial for Liver Retrieval With ex vivo Normothermic Mechanical Perfusion From Cardiac Dead Donor Rats

et al. 2021

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Background: Normothermic machine perfusion (NMP) could be beneficial for organ retrieval from donors after cardiac death (DCD). Activating transcription factor 6 (ATF6) was recently shown to mitigate liver ischemia/reperfusion injury and confer protection. The aims of this study were to assess the implication of ATF6 in liver retrieval from DCD rat livers with NMP and explore the effect of pharmacologic ATF-6 activation on liver retrieval.Methods: The livers from DCD rats were exposed to 30 min of warm ischemia and 8 h cold preservation followed by 2 h NMP with or without an ATF6 activator in the perfusate. Perfusates and livers were harvested to detect ATF6 expression, liver function, and inflammation.Results: DCD livers with NMP were associated with ATF6 overexpression and activation based on IHC and WB (P < 0.05). The ATF6 activator downregulated perfusate aminotransferases, decreased the Suzuki score, downregulated CD68 and MPO based on IHC, induced the expression of cytochrome c in mitochondria and inhibited the expression of cytochrome c in cytoplasm based on WB, reduced TNFα and IL-6 levels based on ELISA, decreased levels of MDA, GSSG and ATP, and increased SOD activity and GSH levels in the perfused livers (P < 0.05).Conclusion: ATF6 is important for liver retrieval, and an exogenous ATF6 activator accelerates liver retrieval from DCD rats in an ex vivo NMP model.

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How to Preserve Liver Grafts From Circulatory Death With Long Warm Ischemia? A Retrospective Italian Cohort Study With Normothermic Regional Perfusion and Hypothermic Oxygenated Perfusion

Cited by 72 publications

References 38 publications

A multicentre outcome analysis to define global benchmarks for donation after circulatory death liver transplantation

A multicentre outcome analysis to define global benchmarks for donation after circulatory death liver transplantation

Consensus statement on normothermic regional perfusion in donation after circulatory death: Report from the European Society for Organ Transplantation’s Transplant Learning Journey

Pharmacological Activating Transcription Factor 6 Activation Is Beneficial for Liver Retrieval With ex vivo Normothermic Mechanical Perfusion From Cardiac Dead Donor Rats

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