| Literature DB >> 29670285 |
David Nasralla1, Constantin C Coussios2, Hynek Mergental3, M Zeeshan Akhtar4,5, Andrew J Butler6, Carlo D L Ceresa4, Virginia Chiocchia7,8, Susan J Dutton9, Juan Carlos García-Valdecasas10, Nigel Heaton11, Charles Imber12, Wayel Jassem11, Ina Jochmans13,14, John Karani11,15, Simon R Knight4,16, Peri Kocabayoglu17, Massimo Malagò12, Darius Mirza3, Peter J Morris4,16, Arvind Pallan18, Andreas Paul17, Mihai Pavel10, M Thamara P R Perera3, Jacques Pirenne13,14, Reena Ravikumar4, Leslie Russell19, Sara Upponi20, Chris J E Watson6,21, Annemarie Weissenbacher4, Rutger J Ploeg4, Peter J Friend22.
Abstract
Liver transplantation is a highly successful treatment, but is severely limited by the shortage in donor organs. However, many potential donor organs cannot be used; this is because sub-optimal livers do not tolerate conventional cold storage and there is no reliable way to assess organ viability preoperatively. Normothermic machine perfusion maintains the liver in a physiological state, avoids cooling and allows recovery and functional testing. Here we show that, in a randomized trial with 220 liver transplantations, compared to conventional static cold storage, normothermic preservation is associated with a 50% lower level of graft injury, measured by hepatocellular enzyme release, despite a 50% lower rate of organ discard and a 54% longer mean preservation time. There was no significant difference in bile duct complications, graft survival or survival of the patient. If translated to clinical practice, these results would have a major impact on liver transplant outcomes and waiting list mortality.Entities:
Mesh：
Year: 2018 PMID： 29670285 DOI： 10.1038/s41586-018-0047-9
Source DB: PubMed Journal: Nature ISSN： 0028-0836 Impact factor: 49.962