Optimising post-conditioning time of marginal donor livers

Manekeller, Steffen; Seinsche, Alexandra; Stegemann, Judith; Hirner, A.

doi:10.1007/s00423-008-0288-4

Cited by 3 publications

(1 citation statement)

References 38 publications

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“…Furthermore, T cell infiltration in liver grafts as well as blood levels of circulating activated T cells decreased (28). A short time (1 h) of reconditioning of DCD rat and porcine livers using HMP after up to 16 h of SCS showed improvements in organ quality (58,64). Long-term (24 h) HMP of DCD rat livers markedly reduced HLA class II antigen expression on post-sinusoidal venular endothelium compared to SCS (55).…”

Section: Hypothermic Machine Perfusion Techniquesmentioning

confidence: 99%

Machine Perfusion of Extended Criteria Donor Organs: Immunological Aspects

et al. 2020

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Due to higher vulnerability and immunogenicity of extended criteria donor (ECD) organs used for organ transplantation (Tx), the discovery of new treatment strategies, involving tissue allorecognition pathways, is important. The implementation of machine perfusion (MP) led to improved estimation of the organ quality and introduced the possibility to achieve graft reconditioning prior to Tx. A significant number of experimental and clinical trials demonstrated increasing support for MP as a promising method of ECD organ preservation compared to classical static cold storage. MP reduced ischemia-reperfusion injury resulting in the protection from inadequate activation of innate immunity. However, there are no general agreements on MP protocols, and clinical application is limited. The objective of this comprehensive review is to summarize literature on immunological effects of MP of ECD organs based on experimental studies and clinical trials.

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Section: Hypothermic Machine Perfusion Techniquesmentioning

confidence: 99%

Machine Perfusion of Extended Criteria Donor Organs: Immunological Aspects

et al. 2020

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Optimal Conditions for Oxygenated Subnormothermic Machine Perfusion for Liver Grafts Using a Novel Perfusion Device

Nishimaki

Miyagi

Kashiwadate

et al. 2022

Transplantation Proceedings

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Donation after cardio-circulatory death liver transplantation

Dinh

Roover

Kaba

et al. 2012

WJG

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The renewed interest in donation after cardio-circulatory death (DCD) started in the 1990s following the limited success of the transplant community to expand the donation after brain-death (DBD) organ supply and following the request of potential DCD families. Since then, DCD organ procurement and transplantation activities have rapidly expanded, particularly for non-vital organs, like kidneys. In liver transplantation (LT), DCD donors are a valuable organ source that helps to decrease the mortality rate on the waiting lists and to increase the availability of organs for transplantation despite a higher risk of early graft dysfunction, more frequent vascular and ischemia-type biliary lesions, higher rates of re-listing and re-transplantation and lower graft survival, which are obviously due to the inevitable warm ischemia occurring during the declaration of death and organ retrieval process. Experimental strategies intervening in both donors and recipients at different phases of the transplantation process have focused on the attenuation of ischemia-reperfusion injury and already gained encouraging results, and some of them have found their way from pre-clinical success into clinical reality. The future of DCD-LT is promising. Concerted efforts should concentrate on the identification of suitable donors (probably Maastricht category III DCD donors), better donor and recipient matching (high risk donors to low risk recipients), use of advanced organ preservation techniques (oxygenated hypothermic machine perfusion, normothermic machine perfusion, venous systemic oxygen persufflation), and pharmacological modulation (probably a multi-factorial biologic modulation strategy) so that DCD liver allografts could be safely utilized and attain equivalent results as DBD-LT.

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Optimising post-conditioning time of marginal donor livers

Abstract: It can be concluded that a PC of 1 h after cold storage can ameliorate the organ viability of marginal livers. The extension or abbreviation of PC time seems to have no further beneficial effects.

Cited by 3 publications

References 38 publications

Machine Perfusion of Extended Criteria Donor Organs: Immunological Aspects

Machine Perfusion of Extended Criteria Donor Organs: Immunological Aspects

Optimal Conditions for Oxygenated Subnormothermic Machine Perfusion for Liver Grafts Using a Novel Perfusion Device

Donation after cardio-circulatory death liver transplantation

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