Author:

Keywords:

Science & Technology, Multidisciplinary Sciences, Science & Technology - Other Topics, ISCHEMIC CHOLANGIOPATHY, REPERFUSION INJURY, RISK-FACTORS, PERFUSION, DEATH, ALLOGRAFTS, DONATION, Adolescent, Adult, Aged, Aged, 80 and over, Allografts, Bile Ducts, Female, Graft Survival, Humans, Length of Stay, Liver, Liver Transplantation, Male, Middle Aged, Organ Preservation, Perfusion, Survival Analysis, Temperature, Tissue Donors, Tissue and Organ Harvesting, Treatment Outcome, Waiting Lists, Young Adult, Consortium for Organ Preservation in Europe, COPE - 305934;info:eu-repo/grantAgreement/EC/FP7/305934, General Science & Technology

Abstract:

Liver transplantation is a highly successful treatment, but is severely limited by the shortage in donor organs. However, many potential donor organs cannot be used; this is because sub-optimal livers do not tolerate conventional cold storage and there is no reliable way to assess organ viability preoperatively. Normothermic machine perfusion maintains the liver in a physiological state, avoids cooling and allows recovery and functional testing. Here we show that, in a randomized trial with 220 liver transplantations, compared to conventional static cold storage, normothermic preservation is associated with a 50% lower level of graft injury, measured by hepatocellular enzyme release, despite a 50% lower rate of organ discard and a 54% longer mean preservation time. There was no significant difference in bile duct complications, graft survival or survival of the patient. If translated to clinical practice, these results would have a major impact on liver transplant outcomes and waiting list mortality.