Outcomes of DCD liver transplantation using organs treated by hypothermic oxygenated perfusion before implantation

The ability to preserve metabolically active livers ex vivo for 1 week or more could allow repair of poor-quality livers that would otherwise be declined for transplantation. Current approaches for normothermic perfusion can preserve human livers for only 24 h. Here we report a liver perfusion machine that integrates multiple core physiological functions, including automated management of glucose levels and oxygenation, waste-product removal and hematocrit control. We developed the machine in a stepwise fashion using pig livers. Study of multiple ex vivo parameters and early phase reperfusion in vivo demonstrated the viability of pig livers perfused for 1 week without the need for additional blood products or perfusate exchange. We tested the approach on ten injured human livers that had been declined for transplantation by all European centers. After a 7-d perfusion, six of the human livers showed preserved function as indicated by bile production, synthesis of coagulation factors, maintained cellular energy (ATP) and intact liver structure.

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An integrated perfusion machine preserves injured human livers for 1 week.

Objectives:To critically assess centralization policies for highly specialized surgeries in Europe and North America and propose recommendations.Background/Methods:Most countries are increasingly forced to maintain quality medicine at a reasonable cost. An all-inclusive perspective, including health

https://www.zora.uzh.ch/id/eprint/165833/1/document%281%29.pdf

Toward a Consensus on Centralization in Surgery

Normothermic regional perfusion vs. super-rapid recovery in controlled donation after circulatory death liver transplantation.

Objective:The aim of this study was to determine the predictive value of machine perfusate analysis on graft outcome.Background:Ex situ machine perfusion (MP) is gaining increasing interest to potentially repair injured organs and to assess organ function. In the field of liver transplantation, howe

https://www.zora.uzh.ch/id/eprint/183544/1/10.1097_SLA.0000000000003513.pdf

Novel Real-time Prediction of Liver Graft Function During Hypothermic Oxygenated Machine Perfusion Before Liver Transplantation

This multicentric study of 17 high-volume centers presents 12 benchmark values for liver transplantation. Those values, mostly targeting markers of morbidity, were gathered from 2024 “low risk” cases, and may serve as reference to assess outcome of single or any groups of patients.Objective:To propo

/pdf/defining-benchmarks-in-liver-transplantation-a-multicenter-2s71fbdeo5.pdf

Kyle Jacskon

Papers

Defining Benchmarks in Liver Transplantation: A Multicenter Outcome Analysis Determining Best Achievable Results.