scholarly journals First human liver transplantation using a marginal allograft resuscitated by normothermic machine perfusion

2015 ◽  
Vol 22 (1) ◽  
pp. 120-124 ◽  
Author(s):  
Thamara Perera ◽  
Hynek Mergental ◽  
Barney Stephenson ◽  
Garrett R. Roll ◽  
Hentie Cilliers ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Human Liver ◽  
Machine Perfusion ◽  
Normothermic Machine Perfusion

scholarly journals Human liver stem cell‐derived extracellular vesicles reduce injury in a model of normothermic machine perfusion of rat livers previously exposed to a prolonged warm ischemia

2021 ◽  
Vol 34 (9) ◽  
pp. 1607-1617
Author(s):  
Nicola De Stefano ◽  
Victor Navarro‐Tableros ◽  
Dorotea Roggio ◽  
Alberto Calleri ◽  
Federica Rigo ◽  
...  
Keyword(s):  
Stem Cell ◽  
Extracellular Vesicles ◽  
Human Liver ◽  
Warm Ischemia ◽  
Machine Perfusion ◽  
Normothermic Machine Perfusion ◽  
Rat Livers

scholarly journals The 24-hour normothermic machine perfusion of discarded human liver grafts

2017 ◽  
Vol 23 (2) ◽  
pp. 207-220 ◽  
Author(s):  
Thomas Vogel ◽  
Jens G. Brockmann ◽  
Alberto Quaglia ◽  
Alireza Morovat ◽  
Wayel Jassem ◽  
...  
Keyword(s):  
Human Liver ◽  
Machine Perfusion ◽  
Normothermic Machine Perfusion

Recent advances in liver transplantation

2021 ◽  
pp. flgastro-2020-101425
Author(s):  
N Thomas Burke ◽  
James B Maurice ◽  
David Nasralla ◽  
Jonathan Potts ◽  
Rachel Westbrook
Keyword(s):  
Liver Transplantation ◽  
Survival Rates ◽  
Machine Perfusion ◽  
Allocation System ◽  
Life Saving ◽  
Opt Out ◽  
Normothermic Machine Perfusion ◽  
Marginal Grafts ◽  
Legislative Changes ◽  
The Uk

Liver transplant is a life-saving treatment with 1-year and 5-year survival rates of 90% and 70%, respectively. However, organ demand continues to exceed supply, such that many patients will die waiting for an available organ. This article reviews for the general gastroenterologist the latest developments in the field to reduce waiting list mortality and maximise utilisation of available organs. The main areas covered include legislative changes in organ donation and the new ‘opt-out’ systems being rolled out in the UK, normothermic machine perfusion to optimise marginal grafts, a new national allocation system to maximise benefit from each organ and developments in patient ‘prehabilitation’ before listing. Current areas of research interest, such as immunosuppression withdrawal, are also summarised.

scholarly journals Machine Perfusion: Cold versus Warm, versus Neither. Update on Clinical Trials

2020 ◽  
Vol 40 (03) ◽  
pp. 264-281 ◽  
Author(s):  
E. Bonaccorsi-Riani ◽  
I.M.A. Brüggenwirth ◽  
J.E. Buchwald ◽  
S. Iesari ◽  
P.N. Martins
Keyword(s):  
Liver Transplantation ◽  
Clinical Trials ◽  
Ex Situ ◽  
Machine Perfusion ◽  
Correct Trial ◽  
Gold Standard Method ◽  
Liver Preservation ◽  
Mature Phase ◽  
Normothermic Machine Perfusion ◽  
Human Livers

AbstractMachine perfusion (MP) preservation is potentially one of the most significant improvements in the field of liver transplantation in the last 20 years, and it has been considered a promising strategy for improved preservation and ex situ evaluation of extended criteria donor (ECD) organs. However, MP preservation adds significant cost and logistical considerations to liver transplantation. MP protocols are mainly classified according to the perfusion temperature with hypothermic machine perfusion (HMP) and normothermic machine perfusion (NMP) being the two categories most studied so far. After extensive preclinical work, MP entered the clinical setting, and there are now several studies that demonstrated feasibility and safety. However, because of the limited quality of clinical trials, there is no compelling evidence of superiority in preservation quality, and liver MP is still considered experimental in most countries. MP preservation is moving to a more mature phase, where ongoing and future studies will bring new evidence in order to confirm their superiority in terms of clinical outcomes, organ utilization, and cost-effectiveness. Here, we present an overview of all preclinical MP studies using discarded human livers and liver MP clinical trials, and discuss their results. We describe the different perfusion protocols, pitfalls in MP study design, and provide future perspectives. Recent trials in liver MP have revealed unique challenges beyond those seen in most clinical studies. Randomized trials, correct trial design, and interpretation of data are essential to generate the data necessary to prove if MP will be the new gold standard method of liver preservation.

scholarly journals Protective role of normothermic machine perfusion during reduced-size liver transplantation in pigs

2016 ◽  
Vol 22 (7) ◽  
pp. 968-978 ◽  
Author(s):  
Zhi-Bin Zhang ◽  
Wei Gao ◽  
Yuan Shi ◽  
Lei Liu ◽  
Ning Ma ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Protective Role ◽  
Machine Perfusion ◽  
Normothermic Machine Perfusion

Normothermic Machine Perfusion in Liver Transplantation: Feasibility and Promise of Avoiding Recooling Before Engrafting

2019 ◽  
Vol 25 (7) ◽  
pp. 1113-1117 ◽  
Author(s):  
Fabrizio Francesco ◽  
Duilio Pagano ◽  
Gennaro Martucci ◽  
Davide Cintorino ◽  
Salvatore Gruttadauria
Keyword(s):  
Liver Transplantation ◽  
Machine Perfusion ◽  
Normothermic Machine Perfusion

scholarly journals Transcriptomic profiles of human livers undergoing rewarming machine perfusion before transplantation—first insights

2021 ◽  
Author(s):  
Dieter Paul Hoyer ◽  
Sandra Swoboda ◽  
Juergen Walter Treckmann ◽  
Tamas Benkö ◽  
Andreas Paul ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Human Liver ◽  
Molecular Mechanisms ◽  
Machine Perfusion ◽  
Gene Expressions ◽  
Human Liver Tissue ◽  
Transcriptional Changes ◽  
Human Livers ◽  
Next Generation Sequencing Ngs ◽  
Upregulated Genes

AbstractMachine perfusion by controlled oxygenated rewarming (COR) is feasible and safe in clinical application and result in a promising outcome. This study utilizes next-generation sequencing (NGS) to investigate the transcriptome of human liver tissue undergoing COR before liver transplantation. Cold-stored livers were subjected to machine-assisted slow COR for ~120 min before transplantation. Biopsies were taken before (preCOR) and after COR (postCOR) and 1 h after reperfusion (postRep). The samples were sequenced, using RNA-seq to analyze differential transcriptional changes between the different stages and treatments of the grafts. Comparison of differential gene expression preCOR and postCOR demonstrated 10 upregulated genes. postRep 97 and 178 genes were upregulated and 7 and 13 downregulated compared to preCOR and postCOR, respectively. A shift of gene expressions by machine perfusion to the TGF-beta pathway was observed. The present study demonstrates distinct transcriptome profiles associated with machine perfusion by COR and transplantation of human livers. Such data provide a deeper understanding of the molecular mechanisms of machine perfusion technology in human liver transplantation.

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