Outcome of Liver Transplants Using Donors After Cardiac Death With Normothermic Regional Perfusion

An extensive evaluation of hepatic markers of damage and regeneration in controlled and uncontrolled donation after circulatory death

“…A potential way to minimize IRI and reduce the complications rate following DCD liver transplantation (LT) is to restore abdominal organ circulation with oxygenated blood (abdominal normothermic regional perfusion, NRP) using extra-corporeal membrane oxygenation at body temperature [6,7] immediately after the declaration of death. In Italy, the legally bound stand-off period of 20 minutes in both cDCDs and uDCDs [7] led to the mandatory implementation of NRP in these types of donors.…”

“…Extended-criteria donors organs are more susceptible to ischemia/reperfusion injury (IRI) and are associated with a higher incidence of complications, worse outcomes, and higher costs. [1][2][3][4][5][6] Donation after cardio-circulatory death (DCD) represents a specific type of extended-criteria donors whose death is declared on cardiac criteria. [7] DCDs are classified into 4 categories as part of the Maastricht criteria, [7] most of them being controlled category-III donors (cDCDs) or uncontrolled category-II donors (uDCDs).…”

“…The growing demand for organ transplantation has led to an increased utilization of grafts from extended-criteria donors. Extended-criteria donors organs are more susceptible to ischemia/reperfusion injury (IRI) and are associated with a higher incidence of complications, worse outcomes, and higher costs 1–6 . Donation after cardio-circulatory death (DCD) represents a specific type of extended-criteria donors whose death is declared on cardiac criteria 7 .…”

Letter to the Editor: Acute rejection after liver transplantation with machine perfusion versus static cold storage: A systematic review and meta-analysis

“…(3) NRP studies: Gaurav and colleagues reported in detail ACR rates in NMP, NRP, and SCS, which could also be included, though both NMP and NRP groups shared 1 SCS control. The study by Muñoz and colleagues [10] and the study by Rodriguez and colleagues [11] used the same longitudinal cohort.…”

“…Of note, a subgroup analysis on ECD-DBD grafts 7,8,9 should also be conducted to evaluate the effects. NRP studies: Gaurav and colleagues reported in detail ACR rates in NMP, NRP, and SCS, which could also be included, though both NMP and NRP groups shared 1 SCS control. The study by Muñoz and colleagues 10 and the study by Rodriguez and colleagues 11 used the same longitudinal cohort. Compared with Muñoz and colleagues, the study by Rodriguez et al and colleagues contained a larger sample size and the latest data from the same center, which could be included instead.…”