Machine Perfusion for Abdominal Organ Preservation: A Systematic Review of Kidney and Liver Human Grafts

被引:37
|
作者
Bellini, Maria Irene [1 ]
Nozdrin, Mikhail [2 ]
Yiu, Janice [3 ]
Papalois, Vassilios [4 ,5 ]
机构
[1] Belfast City Hosp, Renal Transplant Ctr, Belfast BT9 7AB, Antrim, North Ireland
[2] Imperial Coll London, Sch Med, London SW7 2AZ, England
[3] UCL, Sch Med, London WC1E 6BT, England
[4] Imperial Coll Healthcare NHS Trust, Renal & Transplant Directorate, London W12 0HS, England
[5] Imperial Coll London, Dept Surg & Canc, London SW7 2AZ, England
关键词
machine perfusion; organ preservation; temperature; hypothermic; normothermic; transplant; SINGLE-CENTER EXPERIENCE; STATIC COLD-STORAGE; CARDIAC DEATH; ISCHEMIA TIMES; TRANSPLANTATION; DONORS;
D O I
10.3390/jcm8081221
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Introduction: To match the current organ demand with organ availability from the donor pool, there has been a shift towards acceptance of extended criteria donors (ECD), often associated with longer ischemic times. Novel dynamic preservation techniques as hypothermic or normothermic machine perfusion (MP) are increasingly adopted, particularly for organs from ECDs. In this study, we compared the viability and incidence of reperfusion injury in kidneys and livers preserved with MP versus Static Cold Storage (SCS). Methods: Systematic review and meta-analysis with a search performed between February and March 2019. MEDLINE, EMBASE and Transplant Library were searched via OvidSP. The Cochrane Library and The Cochrane Central Register of Controlled Trials (CENTRAL) were also searched. English language filter was applied. Results: the systematic search generated 10,585 studies, finally leading to a total of 30 papers for meta-analysis of kidneys and livers. Hypothermic MP (HMP) statistically significantly lowered the incidence of primary nonfunction (PMN, p = 0.003) and delayed graft function (DGF, p < 0.00001) in kidneys compared to SCS, but not its duration. No difference was also noted for serum creatinine or eGFR post-transplantation, but overall kidneys preserved with HMP had a significantly longer one-year graft survival (OR: 1.61 95% CI: 1.02 to 2.53, p = 0.04). Differently from kidneys where the graft survival was affected, there was no significant difference in primary non function (PNF) for livers stored using SCS for those preserved by HMP and NMP. Machine perfusion demonstrated superior outcomes in early allograft dysfunction and post transplantation AST levels compared to SCS, but however, only HMP was able to significantly decrease serum bilirubin and biliary stricture incidence compared to SCS. Conclusions: MP improves DGF and one-year graft survival in kidney transplantation; it appears to mitigate early allograft dysfunction in livers, but more studies are needed to prove its potential superiority in relation to PNF in livers.
引用
收藏
页数:16
相关论文
共 50 条
  • [1] Ex-vivo machine perfusion for kidney preservation
    Hamar, Matyas
    Selzner, Markus
    CURRENT OPINION IN ORGAN TRANSPLANTATION, 2018, 23 (03) : 369 - 374
  • [2] Machine Perfusion for Human Heart Preservation: A Systematic Review
    Qin, Guangqi
    Jernryd, Victoria
    Sjoberg, Trygve
    Steen, Stig
    Nilsson, Johan
    TRANSPLANT INTERNATIONAL, 2022, 35
  • [3] Functional Human Liver Preservation and Recovery by Means of Subnormothermic Machine Perfusion
    Bruinsma, Bote G.
    Avruch, James H.
    Weeder, Pepijn D.
    Sridharan, Gautham V.
    Uygun, Basak E.
    Karimian, Negin G.
    Porte, Robert J.
    Markmann, James F.
    Yeh, Heidi
    Uygun, Korkut
    JOVE-JOURNAL OF VISUALIZED EXPERIMENTS, 2015, (98):
  • [4] Optimizing porcine donor kidney preservation with normothermic or hypothermic machine perfusion: A systematic review
    Bouari, Sarah
    Eryigit, Ozgur
    de Bruin, Ron W. F.
    IJzermans, Jan N. M.
    Minnee, Robert C.
    ARTIFICIAL ORGANS, 2021, 45 (11) : 1308 - 1316
  • [5] The Role of Normothermic Machine Perfusion in Extended Criteria Donor Grafts: A New Direction in Liver Graft Assessment and Preservation
    Malkawi, Dima
    Savsani, Kush
    Alfonso, Anjelica
    Lee, Seung Duk
    James, Nicholas
    Sarkar, Devanand
    Imai, Daisuke
    Khan, Aamir
    Sharma, Amit
    Kumaran, Vinay
    Bruno, David
    Cotterell, Adrian
    Levy, Marlon F.
    LIVERS, 2023, 3 (04): : 709 - 726
  • [6] Artificial circulation of the liver: Machine perfusion as a preservation method in liver transplantation
    Vekemans, Katrien
    Liu, Qiang
    Pirenne, Jacques
    Monbaliu, Diethard
    ANATOMICAL RECORD-ADVANCES IN INTEGRATIVE ANATOMY AND EVOLUTIONARY BIOLOGY, 2008, 291 (06): : 735 - 740
  • [7] Split-Liver Ex Situ Machine Perfusion: A Novel Technique for Studying Organ Preservation and Therapeutic Interventions
    Huang, Viola
    Karimian, Negin
    Detelich, Danielle
    Raigani, Siavash
    Geerts, Sharon
    Beijert, Irene
    Fontan, Fermin M.
    Aburawi, Mohamed M.
    Ozer, Sinan
    Banik, Peony
    Lin, Florence
    Karabacak, Murat
    Hafiz, Ehab O. A.
    Porte, Robert J.
    Uygun, Korkut
    Markmann, James F.
    Yeh, Heidi
    JOURNAL OF CLINICAL MEDICINE, 2020, 9 (01)
  • [8] Supplemental oxygen during hypothermic kidney preservation: A systematic review
    O'Callaghan, J. M.
    Pall, K. T.
    Pengel, L. H. M.
    TRANSPLANTATION REVIEWS, 2017, 31 (03) : 172 - 179
  • [9] Machine perfusion: new opportunities in abdominal organ transplantation
    Wettstein Daniel
    Hamar Matyas
    Cseprekal Orsolya
    Jozsef, Toth Szabolcs
    Rozsa Balazs
    Remport Adam
    Mathe Zoltan
    ORVOSI HETILAP, 2018, 159 (46) : 1882 - 1890
  • [10] A Meta-Analysis and Systematic Review of Normothermic and Hypothermic Machine Perfusion in Liver Transplantation
    Mugaanyi, Joseph
    Dai, Lei
    Lu, Changjiang
    Mao, Shuqi
    Huang, Jing
    Lu, Caide
    JOURNAL OF CLINICAL MEDICINE, 2023, 12 (01)