Document Detail

HOPE for Human Liver Grafts obtained from Donors after Cardiac Death.
MedLine Citation:
PMID:  24295869     Owner:  NLM     Status:  Publisher    
BACKGROUND: Due to ethical rules in most countries, long ischemia times are unavoidable prior to organ procurement of donors without a heartbeat, which can cause early graft failure after liver transplantation or late biliary strictures. Hypothermic oxygenated machine perfusion, used prior to graft implantation may rescue these high risk organs.
METHODS: Eight patients with end stage liver diseases received human livers, obtained after controlled cardiac death (Maastricht category III), with a median donor warm ischemia time of 38 minutes, followed by a standard cold flush and static storage at 4°C. Hypothermic oxygenated perfusion (HOPE) was applied for 1-2 h prior to implantation through the portal vein. The HOPE-perfusate was cooled at 10°C and oxygenated (pO2 60kPa) using an ECOPS device (Organ Assist®). Perfusion pressure was maintained below 3mmHg.
RESULTS: Each machine perfused liver graft disclosed excellent early function after transplantation. The release of liver enzymes and kidney function, as well as ICU and hospital stays were comparable or better than in matched liver grafts from brain death donors. No evidence of intrahepatic biliary complications could be documented within a median follow up of 8.5 months.
CONCLUSIONS: This is the first report on cold machine perfusion of human liver grafts obtained after cardiac arrest and subsequent transplantation. Application of HOPE appears well tolerated, easy-to-use, and protective against early and later injuries.
P Dutkowski; A Schlegel; M de Oliveira; B Müllhaupt; P-A Clavien
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-11-29
Journal Detail:
Title:  Journal of hepatology     Volume:  -     ISSN:  1600-0641     ISO Abbreviation:  J. Hepatol.     Publication Date:  2013 Nov 
Date Detail:
Created Date:  2013-12-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8503886     Medline TA:  J Hepatol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013. Published by Elsevier B.V.
Department of Surgery & Transplantation, University Hospital Zurich.
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