A randomized trial of normothermic preservation in liver transplantation.
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Authors
Nasralla, David
Coussios, Constantin C
Mergental, Hynek
Akhtar, M Zeeshan
Butler, Andrew
Ceresa, Carlo DL
Chiocchia, Virginia
Dutton, Susan J
García-Valdecasas, Juan Carlos
Heaton, Nigel
Imber, Charles
Jassem, Wayel
Jochmans, Ina
Karani, John
Knight, Simon R
Kocabayoglu, Peri
Malagò, Massimo
Mirza, Darius
Morris, Peter J
Pallan, Arvind
Paul, Andreas
Pavel, Mihai
Perera, M Thamara PR
Pirenne, Jacques
Ravikumar, Reena
Russell, Leslie
Upponi, Sara
Weissenbacher, Annemarie
Ploeg, Rutger J
Friend, Peter J
Consortium for Organ Preservation in Europe
Publication Date
2018-05Journal Title
Nature
ISSN
0028-0836
Publisher
Springer Science and Business Media LLC
Volume
557
Issue
7703
Pages
50-56
Language
eng
Type
Article
This Version
AM
Physical Medium
Print-Electronic
Metadata
Show full item recordCitation
Nasralla, D., Coussios, C. C., Mergental, H., Akhtar, M. Z., Butler, A., Ceresa, C. D., Chiocchia, V., et al. (2018). A randomized trial of normothermic preservation in liver transplantation.. Nature, 557 (7703), 50-56. https://doi.org/10.1038/s41586-018-0047-9
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.
Keywords
Consortium for Organ Preservation in Europe, Bile Ducts, Liver, Humans, Organ Preservation, Tissue and Organ Harvesting, Treatment Outcome, Length of Stay, Liver Transplantation, Survival Analysis, Perfusion, Temperature, Graft Survival, Adolescent, Adult, Aged, Aged, 80 and over, Middle Aged, Tissue Donors, Waiting Lists, Female, Male, Young Adult, Allografts
Identifiers
External DOI: https://doi.org/10.1038/s41586-018-0047-9
This record's URL: https://www.repository.cam.ac.uk/handle/1810/276902
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