Background. Donation after circulatory death (DCD) in Italy, given its 20-min stand-off period, provides a unique bench test for normothermic regional perfusion (NRP) and dual hypothermic oxygenated machine perfusion (D-HOPE). Methods. We coordinated a multicenter retrospective Italian cohort study with 44 controlled DCD donors, who underwent NRP, to present transplant characteristics and results. To rank our results according to the high donor risk, we matched and compared a subgroup of 37 controlled DCD livers, preserved with NRP and D-HOPE, with static-preserved controlled DCD transplants from an established European program. Results. In the Italian cohort, D-HOPE was used in 84% of cases, and the primary nonfunction rate was 5%. Compared with the matched comparator group, the NRP + D-HOPE group showed a lower incidence of moderate and severe acute kidney injury (stage 2: 8% versus 27% and stage 3: 3% versus 27%; P = 0.001). Ischemic cholangiopathy remained low (2-y proportion free: 97% versus 92%; P = 0.317), despite the high-risk profile resulting from the longer donor warm ischemia in Italy (40 versus 18 min; P < 0.001). Conclusions. These data suggest that NRP and D-HOPE yield good results in DCD livers with prolonged warm ischemia.

De Carlis, R., Schlegel, A., Frassoni, S., Olivieri, T., Ravaioli, M., Camagni, S., et al. (2021). How to preserve liver grafts from circulatory death with long warm ischemia? a retrospective italian cohort study with normothermic regional perfusion and hypothermic oxygenated perfusion. TRANSPLANTATION, 105(11), 2385-2396 [10.1097/TP.0000000000003595].

How to preserve liver grafts from circulatory death with long warm ischemia? a retrospective italian cohort study with normothermic regional perfusion and hypothermic oxygenated perfusion

Lauterio A.;Bagnardi V.;Colledan M.;De Carlis L.
2021

Abstract

Background. Donation after circulatory death (DCD) in Italy, given its 20-min stand-off period, provides a unique bench test for normothermic regional perfusion (NRP) and dual hypothermic oxygenated machine perfusion (D-HOPE). Methods. We coordinated a multicenter retrospective Italian cohort study with 44 controlled DCD donors, who underwent NRP, to present transplant characteristics and results. To rank our results according to the high donor risk, we matched and compared a subgroup of 37 controlled DCD livers, preserved with NRP and D-HOPE, with static-preserved controlled DCD transplants from an established European program. Results. In the Italian cohort, D-HOPE was used in 84% of cases, and the primary nonfunction rate was 5%. Compared with the matched comparator group, the NRP + D-HOPE group showed a lower incidence of moderate and severe acute kidney injury (stage 2: 8% versus 27% and stage 3: 3% versus 27%; P = 0.001). Ischemic cholangiopathy remained low (2-y proportion free: 97% versus 92%; P = 0.317), despite the high-risk profile resulting from the longer donor warm ischemia in Italy (40 versus 18 min; P < 0.001). Conclusions. These data suggest that NRP and D-HOPE yield good results in DCD livers with prolonged warm ischemia.
Articolo in rivista - Articolo scientifico
liver transpolantation, preservation;
English
2385
2396
12
De Carlis, R., Schlegel, A., Frassoni, S., Olivieri, T., Ravaioli, M., Camagni, S., et al. (2021). How to preserve liver grafts from circulatory death with long warm ischemia? a retrospective italian cohort study with normothermic regional perfusion and hypothermic oxygenated perfusion. TRANSPLANTATION, 105(11), 2385-2396 [10.1097/TP.0000000000003595].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/365318
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