Making Every Liver Count: Increased Transplant Yield of Donor Livers Through Normothermic Machine Perfusion.

Annals of Surgery
Malcolm MacConmaraParsia A Vagefi

Abstract

Normothermic machine perfusion (NMP) enables optimized ex-vivo preservation of a donor liver in a normal physiologic state. The impact of this emerging technology on donor liver utilization has yet to be assessed. NMP of the donor liver and ex-vivo enhancement of its function has been envisioned for decades, however only with recent technological advances have devices been suitable for transition to clinical practice. The present study examines the effect NMP on liver utilization in the United States. The United Network for Organ Sharing database was queried to identify deceased donor livers procured from 2016 to 2019 (n = 30596). Donor livers were divided by preservation method: standard cold-static preservation (COLD, n = 30,368) versus NMP (n = 228). Donor and recipient risk factors, liver disposition, and discard reasons were analyzed. The primary outcome was liver discard rate between 2 groups. A total of 4037 livers were discarded. The NMP group had a 3.5% discard rate versus 13.3% in the COLD group (P < 0.001), and this was despite NMP donors being older (47.7 vs 39.5 years, P < 0.0001), more frequently donation after cardiac death (DCD) (18% vs 7%, P < 0.001), and having a greater donor risk index (1.6 vs 1.5, P < 0.05)...Continue Reading

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Citations

Mar 3, 2021·Current Opinion in Organ Transplantation·Hanns Lembach JahnsenDarius F Mirza
Mar 3, 2021·Current Opinion in Organ Transplantation·Chandrashekhar KubalJohn Holden
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Nov 20, 2020·Transplantation·Constantine J KarvellasEmmanuel Weiss
Aug 15, 2021·Advances in Surgery·Malcolm MacConmara, Parsia A Vagefi
Aug 12, 2021·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Alexandria N WebbDavid L Bigam

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