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01-02-2022 | Liver Transplantation | Original Article

The use of normothermic machine perfusion to rescue liver allografts from expanded criteria donors

Authors: Aurelio Seidita, Rosalia Longo, Fabrizio Di Francesco, Alessandro Tropea, Sergio Calamia, Giovanna Panarello, Marco Barbara, Salvatore Gruttadauria

Published in: Updates in Surgery | Issue 1/2022

Abstract

The use of expanded criteria donors is one of the strategies used to overcome the gap between the demand for organs and the number of donors. Physicians debate the extent to which marginal grafts can be used. In recent years, normothermic machine perfusion (NMP) has been used to test liver viability before transplantation. Grafts underwent NMP whenever histological steatosis was > 40% or there were at least three Eurotransplant criteria for expanded criteria donor (ECD). We used NMP to test 19 grafts, 3 from donation after type 3 controlled cardiac death (DCD), and 16 from donation after brain death (DBD). Only two grafts from DBD were not transplanted, because perfusion proved they were not suitable (total of 17 transplanted grafts of 19 tested grafts). Kaplan–Meier survival estimates at 30, 90, 180, and 1 year after transplant were all 94% (95% CI 84–100%); estimated 3-years survival was 82% (95% CI 62–100%). Overall survival rates did not differ from those of patients transplanted with non-perfused grafts from an ECD. In our experience, the use of very marginal grafts preventively tested by NMP does not negatively influence the patient’s outcome, and increases the number of transplants in low donation areas.

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Title: The use of normothermic machine perfusion to rescue liver allografts from expanded criteria donors
Authors: Aurelio Seidita
Rosalia Longo
Fabrizio Di Francesco
Alessandro Tropea
Sergio Calamia
Giovanna Panarello
Marco Barbara
Salvatore Gruttadauria
Publication date: 01-02-2022
Publisher: Springer International Publishing
Keywords: Liver Transplantation
Liver Transplantation
Liver Transplantation
Liver Transplantation
Liver Transplantation
Published in: Updates in Surgery / Issue 1/2022
Print ISSN: 2038-131X
Electronic ISSN: 2038-3312
DOI: https://doi.org/10.1007/s13304-021-01169-2

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The use of normothermic machine perfusion to rescue liver allografts from expanded criteria donors

Abstract

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Abstract

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