Will This Liver Work? The “Ibis Redibis” of Machine Preservation Viability Assessment

Quintini, Cristiano; Prete, Luca Del; Uso, Teresa Diago; Liu, Qiang

doi:10.1002/lt.26411

Cited by 5 publications

(8 citation statements)

References 8 publications

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“…When comparing the HBOC and RBC group, no differences were observed in post-transplant outcomes (Table 4; Figure S2). The median follow-up was 38 months (34)(35)(36)(37)(38)(39)(40)(41) in the HBOC group and 17 months (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25) in the RBC group. Post-operative results are shown in Table 4.…”

Section: Post-operative Resultsmentioning

confidence: 99%

“…It is obvious that selection of donor livers during machine perfusion is rapidly developing and we are all still learning. As was well discussed in a recent editorial by Quintini et al, clinical studies on NMP for (initially discarded) high‐risk donor livers have been designed with patient safety in mind 36 . Consequently, very few failures have been reported.…”

Section: Discussionmentioning

confidence: 99%

“…It is therefore not possible to perform statistical analyses for identification of (new) thresholds and boundaries for viability markers. 36 Only by slowly extending the viability criteria after sufficient confidence has been obtained in the NMP procedure, we and other centers have slowly started to gather more insight in this. With increasing experience and confidence in the protocol, we gradually started to accept livers with some more 'orange' and 'red' values (Tables 1 and 3), as long as the original selection criteria (lactate, arterial pH, bile production, bile pH) had been met at any point during the first 150 minutes of NMP.…”

Section: Ta B L E 3 (Continued)mentioning

confidence: 99%

“…As was well discussed in a recent editorial by Quintini et al, clinical studies on NMP for (initially discarded) high-risk donor livers have been designed with patient safety in mind. 36 Consequently, very few failures have been reported. It is therefore not possible to perform statistical analyses for identification of (new) thresholds and boundaries for viability markers.…”

Section: Ta B L E 3 (Continued)mentioning

confidence: 99%

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Sequential hypothermic and normothermic machine perfusion enables safe transplantation of high-risk donor livers

Leeuwen

Bodewes

Lantinga

et al. 2022

American Journal of Transplantation

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Ex situ normothermic machine perfusion (NMP) is increasingly used for viability assessment of high‐risk donor livers, whereas dual hypothermic oxygenated machine perfusion (DHOPE) reduces ischemia‐reperfusion injury. We aimed to resuscitate and test the viability of initially‐discarded, high‐risk donor livers using sequential DHOPE and NMP with two different oxygen carriers: an artificial hemoglobin‐based oxygen carrier (HBOC) or red blood cells (RBC). In a prospective observational cohort study of 54 livers that underwent DHOPE‐NMP, the first 18 procedures were performed with a HBOC‐based perfusion solution and the subsequent 36 procedures were performed with an RBC‐based perfusion solution for the NMP phase. All but one livers were derived from extended criteria donation after circulatory death donors, with a median donor risk index of 2.84 (IQR 2.52–3.11). After functional assessment during NMP, 34 livers (63% utilization), met the viability criteria and were transplanted. One‐year graft and patient survival were 94% and 100%, respectively. Post‐transplant cholangiopathy occurred in 1 patient (3%). There were no significant differences in utilization rate and post‐transplant outcomes between the HBOC and RBC group. Ex situ machine perfusion using sequential DHOPE‐NMP for resuscitation and viability assessment of high‐risk donor livers results in excellent transplant outcomes, irrespective of the oxygen carrier used.

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Section: Post-operative Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Ta B L E 3 (Continued)mentioning

confidence: 99%

Section: Ta B L E 3 (Continued)mentioning

confidence: 99%

See 2 more Smart Citations

Sequential hypothermic and normothermic machine perfusion enables safe transplantation of high-risk donor livers

Leeuwen

Bodewes

Lantinga

et al. 2022

American Journal of Transplantation

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“…Although different parameters could already be explored in the donor and measured in flush solutions, an active oxygenation is usually required for the release of certain molecules from organs presenting features of IRI 60 . Since MP has regained wider interest within the liver preservation field, many efforts were made to identify better viability criteria 61,62 . Parameters used for liver assessment during NMP were mainly derived from clinical practice with patients admitted to intensive care unit or those with liver failure or after hepatectomy 59 .…”

Section: Hope Allows Real-time Viability Assessment Of Liver Graftsmentioning

confidence: 99%

Hypothermic Machine Perfusion of the Liver. The Reasons for Success

Prete

Franchi²,

Lonati³

et al. 2022

EJT

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Sequential hypothermic and normothermic perfusion preservation and transplantation of expanded criteria donor livers

Liu¹,

Prete²,

Ali³

et al. 2023

Surgery

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Will This Liver Work? The “Ibis Redibis” of Machine Preservation Viability Assessment

Cited by 5 publications

References 8 publications

Sequential hypothermic and normothermic machine perfusion enables safe transplantation of high-risk donor livers

Sequential hypothermic and normothermic machine perfusion enables safe transplantation of high-risk donor livers

Hypothermic Machine Perfusion of the Liver. The Reasons for Success

Sequential hypothermic and normothermic perfusion preservation and transplantation of expanded criteria donor livers

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