Identification and treatment of biliary complications after liver transplantation: more relevant than ever

Moosburner, Simon; Pratschke, Johann; Raschzok, Nathanael

doi:10.21037/hbsn-22-111

Cited by 1 publication

(3 citation statements)

References 16 publications

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“…The greatest improvement could be seen in DCD grafts after D-HOPE+COR+NMP (9% vs 18% in SCS). This finding was to be expected, as ischemic cholangiopathy is associated with DCD grafts and prolonged cold ischemia [40][41][42] Donor age has previously been described as an independent risk factor for biliary complications after liver transplantation [43] We did not observe an association of donor age with higher rates of biliary complications in the populations of our selected studies. However, only donor populations above 60 years were analyzed and the combination of DCD and DBD in study populations merits caution for this statement.…”

Section: Discussionsupporting

confidence: 70%

“…The greatest improvement could be seen in DCD grafts after D‐HOPE+COR+NMP (9% vs 18% in SCS). This finding was to be expected, as ischemic cholangiopathy is associated with DCD grafts and prolonged cold ischemia [ 40–42 ]…”

Section: Discussionmentioning

confidence: 70%

“…[24,27] 2.9. Postoperative Health Care Utilization Rayar et al showed significantly shorter average ICU stay (3 days HOPE vs 5 days SCS, p = 0.01) and hospital stay (15 days HOPE vs 20 days SCS, p = 0.01) (42). Similar results were also obtained by Czigany et al with shorter ICU stays (median 5 days HOPE vs 8 days SCS, p = 0.045) and ICU stays (median 20 days HOPE vs 36 days SCS, P = 0.002).…”

Section: Hepatocellular Damagementioning

confidence: 97%

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Ex Vivo Liver Machine Perfusion Reduces the Length of Hospital Stay in Recipients of Allografts from Elderly Donors: A Systematic Review

Boerger

Hillebrandt

Czigány

et al. 2023

Advanced Therapeutics

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Liver transplantation is the only curative treatment option for end-stage liver disease. As the population ages worldwide, utilization of grafts from elderly donors has the potential to expand the donor pool. Unfortunately, these allografts are associated with increased rates of primary non-function and early allograft dysfunction. Ex vivo machine perfusion (MP) may be a promising technique to overcome these challenges. A systematic review of PubMed, Web of Science, and ClinicalTrials.gov is presented for trials comparing MP to static cold storage for elderly human allografts (≥70 years) (PROSPERO ID352930). Six clinical trials (n = 1189 patients) are included. Hypothermic oxygenated perfusion (HOPE) is used in five trials and normothermic MP (NMP) in one trial. There is limited evidence that machine perfusion has the potential to mitigate the risks associated with older livers and shorten the length of hospital stay after transplantation. There is no evidence to support superiority of one perfusion type or differences in patient and graft survival. Risk of bias is high, and level of evidence is limited regarding MP of allografts form elderly donors. Nevertheless, MP is associated with length of hospital stay. Further research is warranted to analyze MP for allografts of older age.

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