Transplantation of a human liver following 3 days of ex situ normothermic preservation

Clavien, Pierre‐Alain; Dutkowski, Philipp; Mueller, Matteo; Eshmuminov, Dilmurodjon; Borrego, Lucía Bautista; Weber, Achim; Muellhaupt, Beat; Silva, Richard X. Sousa Da; Burg, Brian R.; Rohr, Philipp Rudolf von; Schüler, Martin; Becker, Dustin; Hefti, Max; Tibbitt, Mark W.

doi:10.1038/s41587-022-01354-7

Cited by 89 publications

(76 citation statements)

References 35 publications

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“…This perfusion technique may, however, work well in cases with limited injury, such as short warm or cold ischemia times [ 130 , 133 , 134 ]. This was recently confirmed with the achievement of a prolonged 3-day NMP of a low-risk human liver with subsequent implantation [ 135 ].…”

Section: Strategies With the Potential To Reduce Cancer Recurrencementioning

confidence: 74%

Mitochondria and Cancer Recurrence after Liver Transplantation—What Is the Benefit of Machine Perfusion?

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Carvalho

Eden

et al. 2022

IJMS

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Tumor recurrence after liver transplantation has been linked to multiple factors, including the recipient’s tumor burden, donor factors, and ischemia-reperfusion injury (IRI). The increasing number of livers accepted from extended criteria donors has forced the transplant community to push the development of dynamic perfusion strategies. The reason behind this progress is the urgent need to reduce the clinical consequences of IRI. Two concepts appear most beneficial and include either the avoidance of ischemia, e.g., the replacement of cold storage by machine perfusion, or secondly, an endischemic organ improvement through perfusion in the recipient center prior to implantation. While several concepts, including normothermic perfusion, were found to reduce recipient transaminase levels and early allograft dysfunction, hypothermic oxygenated perfusion also reduced IRI-associated post-transplant complications and costs. With the impact on mitochondrial injury and subsequent less IRI-inflammation, this endischemic perfusion was also found to reduce the recurrence of hepatocellular carcinoma after liver transplantation. Firstly, this article highlights the contributing factors to tumor recurrence, including the surgical and medical tissue trauma and underlying mechanisms of IRI-associated inflammation. Secondly, it focuses on the role of mitochondria and associated interventions to reduce cancer recurrence. Finally, the role of machine perfusion technology as a delivery tool and as an individual treatment is discussed together with the currently available clinical studies.

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Section: Strategies With the Potential To Reduce Cancer Recurrencementioning

confidence: 74%

Mitochondria and Cancer Recurrence after Liver Transplantation—What Is the Benefit of Machine Perfusion?

Parente

Carvalho

Eden

et al. 2022

IJMS

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“…Several internationally recognised developments for the treatment of liver diseases have been developed in recent years at the Swiss HPB centre, in collaboration with our research laboratories at the University Hospital or Federal Institute of Technology (ETH). 50,51 We have achieved a large part of what we set out to do when we founded the centre. Patients with HPB diseases are centralised and managed at the centre.…”

Section: Swiss Hpb Centrementioning

confidence: 99%

The essential requirements for an HPB centre to deliver high-quality outcomes

Ignatavičius¹,

Oberkofler²,

Jonas³

et al. 2022

Journal of Hepatology

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“…1 Another recent study reporting the use for LT of a 3-d normothermically perfused graft reported the absence of relevant IRI after LT, also thanks to the inclusion of platelets into the NMP system. 9 The exact mechanism of platelets should be clarified in the setting of NMP: a double effect should be driven, on the one side favoring inflammation-related damage, and on the other side, consenting a repair of the damage itself. Adding the 2 platelet-related parameters, MPV and PDW, during graft evaluation in NMP could be used, in our opinion, to optimize the decision on the graft viability and prevent postoperative complications.…”

Section: Perfusate Enzymes and Platelets Indicate Early Allograft Dys...mentioning

confidence: 99%

mentioning

confidence: 99%

Perfusate Enzymes and Platelets Indicate Early Allograft Dysfunction After Transplantation of Normothermically Preserved Livers

2022

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Transplantation of a human liver following 3 days of ex situ normothermic preservation

Cited by 89 publications

References 35 publications

Mitochondria and Cancer Recurrence after Liver Transplantation—What Is the Benefit of Machine Perfusion?

Mitochondria and Cancer Recurrence after Liver Transplantation—What Is the Benefit of Machine Perfusion?

The essential requirements for an HPB centre to deliver high-quality outcomes

Perfusate Enzymes and Platelets Indicate Early Allograft Dysfunction After Transplantation of Normothermically Preserved Livers

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