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Upper limit of normothermic machine preservation of liver grafts from donation after circulatory death yet to be defined

引用

World Journal of Transplantation 2025年第2期15卷 218-227页

作者： William H Archie Maria Baimas-George Nathanael Haynes Souma Kundu Katheryn Peterson Chase J Wehrle damien huckleberry Lon Eskind David Levi Jose R Soto Roger Denny Vincent Casingal Allyson Cochran Erin H Rein Dionisios Vrochides Division of Adominal Transplant Department of SurgeryCarolinas Medical CenterCharlotteNC 28203United States Department of Hepato-Pancreato-Biliary/Liver Transplant Surgery Cleveland Clinic Transplant Research CenterClevelandOH 44195United States Department of Surgery Carolinas Center for Surgical Outcomes ScienceCarolinas Medical CenterCharlotteNC 28203United States

BACKGROUND The normothermic machine perfusion pump(NMPP)could shape the future of *** ex-vivo optimization,NMPP attenuates ischemic insult while replenishing *** understanding of machine perfusion time(MPT)impact and potential clinical benefits is paramount and necessitates *** To investigate the relationship between MPT and post-transplant graft *** Retrospective review of the first 50 donation after circulatory death(DCD)grafts preserved using NMPP in a tertiary institution was *** preser-vation time points,graft parameters,recipient information,and postoperative outcomes were prospectively *** allograft dysfunction(EAD),L-Graft7 score and 90-day outcomes were collected for all *** first 20 re-cipients were allocated into the early group,considered the learning curve population for the *** subsequent 30 were allocated into the late *** were also stratified into cohorts depending on MPT,i.e.,short(16 hours).RESULTS NMPP operational parameters were not predictive of EAD,L-GrAFT7 or 90-day *** early group had significantly less MPT and cold ischemia time than the late group(553 minutes vs 850 minutes,P<0.001)and(127.5 minutes vs 154 minutes,P=0.025),*** had no impact in either *** Increased MPT of DCD liver grafts had no adverse recipient results for the times utilized in this population,indicating its upper limits,likely beyond 24 hours,are not demonstrated within this *** studies are necessary to determine whether longer MPT is beneficial or detrimental to graft function and,if the latter,what is the maximum safe *** studies of the effect of normothermic machine perfusion pump duration on long-term outcomes are also needed.

关键词： Normothermic machine pump perfusion Liver transplant Donation after circulatory death Ex-vivo perfusion Ischemic cholangiopathy

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