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01-04-2022 | Liver Transplantation | Original Article

Current practice of normothermic regional perfusion and machine perfusion in donation after circulatory death liver transplants in Italy

Authors: Riccardo De Carlis, Andrea Lauterio, Leonardo Centonze, Vincenzo Buscemi, Andrea Schlegel, Paolo Muiesan, Luciano De Carlis, Italian DCD Collaborator Group

Published in: Updates in Surgery | Issue 2/2022

Abstract

Background

Normothermic regional perfusion (NRP) and machine perfusion (MP) are variously used in many European centers to improve the outcomes after liver transplantation from donation after circulatory death (DCD). In Italy, a combination of NRP and subsequent MP has been used since the start of the activity. While NRP is mandatory for every DCD recovery, the subsequent use of MP is left to each center.

Methods

We have designed a national survey to investigate practices and policies of these techniques. The questionnaire included 46 questions and was distributed to all the 21 Italian centers using an online form between June and July 2021.

Results

The overall response rate was 100%. A local NRP program for controlled Maastricht type 3 DCD was active in 11/21 (52.4%) centers. Organization and availability of personnel were perceived as the main difficulties in starting such a program. Between 2015 and 2020, 119 DCD livers were transplanted, with an overall utilization rate of 69.2%. Pump flow and gross aspect were considered the most reliable parameters in liver selection during NRP. Eight (72.7%) centers adopted subsequent hypothermic MP, 1 (9.1%) center normothermic MP, and the remaining 2 (18.2%) used both MP types.

Conclusion

This first snapshot survey shows that NRP with subsequent MP is the most used protocol in Italy for DCD livers, although some heterogeneity exists in the type and purpose of MP between centers. Overall, this policy ensures a high utilization rate, considering the high risk of the DCD donor population in Italy.

Graphical abstract

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Title: Current practice of normothermic regional perfusion and machine perfusion in donation after circulatory death liver transplants in Italy
Authors: Riccardo De Carlis
Andrea Lauterio
Leonardo Centonze
Vincenzo Buscemi
Andrea Schlegel
Paolo Muiesan
Luciano De Carlis
Italian DCD Collaborator Group
Publication date: 01-04-2022
Publisher: Springer International Publishing
Keywords: Liver Transplantation
Liver Transplantation
Liver Transplantation
Liver Transplantation
Liver Transplantation
Published in: Updates in Surgery / Issue 2/2022
Print ISSN: 2038-131X
Electronic ISSN: 2038-3312
DOI: https://doi.org/10.1007/s13304-022-01259-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Current practice of normothermic regional perfusion and machine perfusion in donation after circulatory death liver transplants in Italy

Abstract

Background

Methods

Results

Conclusion

Graphical abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Graphical abstract

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