Cold Perfusion cuts Liver Transplant complications
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Compared with conventional static cold storage, hypothermic oxygenated machine perfusion resulted in a lower risk of non-anastomotic biliary strictures 6 months after liver transplants were received from donors after circulatory death (DCD), a multicenter randomized study found.

In this multicenter, controlled trial, researchers randomly assigned patients who were undergoing transplantation of a liver obtained from a donor after circulatory death to receive that liver either after hypothermic oxygenated machine perfusion (machine-perfusion group) or after conventional static cold storage alone (control group). The primary endpoint was the incidence of nonanastomotic biliary strictures within 6 months after transplantation. Secondary endpoints included other graft-related and general complications.

A total of 160 patients were enrolled, of whom 78 received a machine-perfused liver and 78 received a liver after static cold storage only.

The study showed;
--Nonanastomotic biliary strictures occurred in 6% of the patients in the machine-perfusion group and in 18% of those in the control group.

--Postreperfusion syndrome occurred in 12% of the recipients of a machine-perfused liver and in 27% of those in the control group.

--Early allograft dysfunction occurred in 26% of the machine-perfused livers, as compared with 40% of control livers.

--The cumulative number of treatments for nonanastomotic biliary strictures was lower by a factor of almost 4 after machine perfusion, as compared with control.

--The incidence of adverse events was similar in the two groups.

In particular, hypothermic oxygenated machine perfusion led to a lower risk of nonanastomotic biliary strictures following the transplantation of livers obtained from donors after circulatory death than conventional static cold storage.

New England Journal of Medicine
Source: https://www.nejm.org/doi/full/10.1056/NEJMoa2031532
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