A Systematic Review and Meta-Analysis of Machine Perfusion vs. Static Cold Storage of Liver Allografts on Liver Transplantation Outcomes: The Future Direction of Graft Preservation

Frontiers in Medicine
Jun-Jun JiaShu-Sen Zheng

Abstract

Background: Machine perfusion (MP) and static cold storage (CS) are two prevalent methods for liver allograft preservation. However, the preferred method remains controversial. Aim: To conduct a meta-analysis on the impact of MP preservation on liver transplant outcome. Methods: PubMed, EMBASE, and Cochrane Library databases were systematically searched to identify relevant trials comparing the efficacy of MP vs. CS. Odds ratios (OR) and fixed-effects models were calculated to compare the pooled data. Results: Ten prospective cohort studies and two randomized controlled trials (RCTs) were included (MP livers vs. CS livers = 315:489). Machine perfusion demonstrated superior outcomes in posttransplantation aspartate aminotransferase levels compared to CS (P < 0.05). The overall incidence of early allograft dysfunction (EAD) was significantly reduced with MP preservation than CS [OR = 0.46; 95% confidence interval (CI) = 0.31-0.67; P < 0.0001]. The incidence of total biliary complications (OR = 0.53; 95% CI = 0.34-0.83; P = 0.006) and that of ischemic cholangiopathy (OR = 0.39; 95% CI = 0.18-0.85; P = 0.02) were significantly lower in recipients with MP preservation compared with CS preservation. Hypothermic machine perfusion (HMP...Continue Reading

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Citations

Aug 23, 2020·International Journal of Molecular Sciences·Raji BaidyaKim R Bridle
Sep 16, 2020·International Journal of Molecular Sciences·Mindaugas KvietkauskasPeter Schemmer
Feb 19, 2021·Frontiers in Surgery·Samuel J TingleColin Wilson
Apr 4, 2021·International Journal of Molecular Sciences·Tamara HorváthPetra Hartmann
Apr 14, 2021·Seminars in Cardiothoracic and Vascular Anesthesia·Ryan F WangTetsuro Sakai
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Oct 30, 2021·ACS Nano·Bilal HussainReza Abdi

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