Journal ArticleDOI
Liver perfusion devices: how close are we to widespread application?
TLDR
Although initial clinical results are promising, higher level evidence is still needed to justify more widespread application of machine perfusion in human liver transplantation.Abstract:
PURPOSE OF REVIEW Ex-situ liver machine perfusion has been the focus of increasing interest over the past decade as a means to improve the quality of livers for transplantation and the applicability of liver transplantation in general. The present review aims to evaluate the experimental basis for liver machine perfusion and the significance of recent reports on its clinical application. RECENT FINDINGS Although liver machine perfusion has been studied experimentally over a range of temperatures, clinical liver transplant work that has been performed to date has been done using either hypothermic machine perfusion (0-12 °C), HMP or normothermic machine perfusion (35-38 °C, NMP). Both HMP and NMP have been studied clinically in the context of phase I trials demonstrating the feasibility of their application. It has also been shown through a small number of cases that NMP may serve as a useful means to evaluate initially discarded livers to determine viability for subsequent transplantation. SUMMARY Although initial clinical results are promising, higher level evidence is still needed to justify more widespread application of machine perfusion in human liver transplantation.read more
Citations
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Journal ArticleDOI
Organ Preservation into the 2020s: The Era of Dynamic Intervention
Alexander Y. Petrenko,Matías Emanuel Carnevale,Alexander Y. Somov,Juliana Soledad Osorio,Joaquín V. Rodríguez,Edgardo E. Guibert,Edgardo E. Guibert,Barry Fuller,Farid Froghi +8 more
TL;DR: This review focuses on new information about the cell and molecular events impacting on ischemia/reperfusion injury during organ preservation, strategies which use varied compositions and additives in organ preservation solutions to deal with these and clear definitions of the developing protocols for dynamic organ perfusion preservation.
Journal ArticleDOI
Sequential Use of Normothermic Regional and Ex Situ Machine Perfusion in Donation After Circulatory Death Liver Transplant
Davide Ghinolfi,Daniele Dondossola,Erion Rreka,Caterina Lonati,Daniele Pezzati,Andrea Cacciatoinsilla,Alessia Kersik,Chiara Lazzeri,Alberto Zanella,Adriano Peris,Marco Maggioni,Giandomenico Luigi Biancofiore,Paolo Reggiani,Riccardo Morganti,Paolo De Simone,Giorgio Rossi +15 more
TL;DR: Strict NRP and ex situ MP selection criteria are needed to optimize postoperative results in DCD LTs, which is feasible even with the 20‐minute no‐touch rule.
Journal ArticleDOI
Preliminary Experience With Hypothermic Oxygenated Machine Perfusion in an Italian Liver Transplant Center.
Daniele Dondossola,Caterina Lonati,Alberto Zanella,Marco Maggioni,B. Antonelli,Paolo Reggiani,Stefano Gatti,Giorgio Rossi +7 more
TL;DR: This study confirms HOPE safety and efficacy for DCD and DBD grafts in the Italian setting where the mandatory 20-minute hands-off interval before death declaration further prolongs warm ischemia time.
Journal ArticleDOI
Implementing an innovated preservation technology: The American Society of Transplant Surgeons' (ASTS) Standards Committee White Paper on Ex Situ Liver Machine Perfusion.
Cristiano Quintini,Paulo N. Martins,Shimul A. Shah,Mary Killackey,Alan I. Reed,James V. Guarrera,David A. Axelrod +6 more
TL;DR: The American Society of Transplant Surgeons’ belief that organ preservation technology is a vital advance, but its use should not change fundamental aspects of organ allocation is described.
Journal ArticleDOI
Hypothermic oxygenated machine perfusion alleviates liver injury in donation after circulatory death through activating autophagy in mice
Xianpeng Zeng,Shengjie Wang,Shiyi Li,Yunying Yang,Fang Zehong,Honglei Huang,Yanfeng Wang,Xiaoli Fan,Qifa Ye,Qifa Ye +9 more
TL;DR: Hypothermic oxygenated machine perfusion alleviated DCD liver injury by increasing autophagy levels further in this mouse model and may provide a new strategy for alleviating DCD Liver injury in clinical practice.
References
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