A randomized trial of normothermic preservation in liver transplantation

@article{Nasralla2018ART,
  title={A randomized trial of normothermic preservation in liver transplantation},
  author={D. Nasralla and C. Coussios and H. Mergental and M. Z. Akhtar and A. Butler and C. Ceresa and V. Chiocchia and S. Dutton and J. Garc{\'i}a-Valdecasas and N. Heaton and C. Imber and W. Jassem and I. Jochmans and J. Karani and S. Knight and P. Kocabayoglu and M. Malago' and D. Mirza and P. Morris and A. Pallan and A. Paul and M. Pavel and M. Perera and J. Pirenne and R. Ravikumar and L. Russell and S. Upponi and C. Watson and A. Weissenbacher and R. Ploeg and P. Friend and For Europe},
  journal={Nature},
  year={2018},
  volume={557},
  pages={50-56}
}
Liver transplantation is a highly successful treatment, but is severely limited by the shortage in donor organs. However, many potential donor organs cannot be used; this is because sub-optimal livers do not tolerate conventional cold storage and there is no reliable way to assess organ viability preoperatively. Normothermic machine perfusion maintains the liver in a physiological state, avoids cooling and allows recovery and functional testing. Here we show that, in a randomized trial with 220… Expand

Paper Mentions

Interventional Clinical Trial
Prospective, randomized, controlled clinical trial to determine the overall efficacy of normothermic machine perfusion (NMP) for steatotic liver preservation versus traditional… Expand
ConditionsLiver Transplant
InterventionDevice, Procedure
The Role of Normothermic Machine Perfusion in Liver Transplantation.
TLDR
The history, current status including outcomes of all clinical trials, limitations, and future trends of normothermic machine preservation are reviewed. Expand
Normothermic perfusion and outcomes after liver transplantation.
TLDR
Issues relevant to use of normothermic perfusion strategies in liver transplantation are addressed, including technical and logistical aspects associated with establishing and maintaining normotherm perfusion in its different forms and clinical outcomes that have been reported to date. Expand
Preserving the liver for transplantation
  • K. Ray
  • Medicine
  • Nature Reviews Gastroenterology & Hepatology
  • 2018
TLDR
NMP is feasible and effective for organ preservation and, if successfully translated to clinical practice, could reduce tissue injury associated with liver transplants and enable better assessment of organ quality to ultimately improve liver transplantation outcomes, reports a trial published in Nature. Expand
Transplantation of discarded livers following viability testing with normothermic machine perfusion
TLDR
It is demonstrated that viability testing with NMP is feasible and in this study enabled successful transplantation of 71% of discarded livers, with 100% 90-day patient and graft survival; it does not seem to prevent non-anastomotic biliary strictures in livers donated after circulatory death with prolonged warm ischaemia. Expand
Machine perfusion in abdominal organ transplantation: Current use in the Netherlands.
TLDR
Despite the lack of evidence from randomized controlled trials, currently available data suggest especially beneficial effects of normothermic regional perfusion on biliary complications and ischemic cholangiopathy after liver transplantation. Expand
Normothermic Machine Perfusion (NMP) Inhibits Proinflammatory Responses in the Liver and Promotes Regeneration
TLDR
Reduced IRI in NMP recipients was the consequence of the combination of inhibiting inflammation and promoting graft regeneration, and the underlying mechanisms were defined. Expand
Transplanting Marginal Organs in the Era of Modern Machine Perfusion and Advanced Organ Monitoring
TLDR
The current state of MP and advanced organ monitoring is addressed and speculation about logical future steps and how this evolution of a novel technology can result in a medial revolution is speculated. Expand
Liver transplantation without graft ischemia in humans
TLDR
IFLT provides a new approach to minimize ischemia-reperfusion injury and improve post-transplant outcomes and the extended criteria donor livers in IFLT yielded faster posttransplant recovery than the standard criteria donors in CLT. Expand
Liver graft preservation methods during cold ischemia phase and normothermic machine perfusion
TLDR
Normothermic machine perfusion may help to estimate graft functionality before implantation into a recipient, and NMP is actively evaluating promising method for this purpose. Expand
Current review of machine perfusion in liver transplantation from the Japanese perspective
TLDR
Machine perfusion is opening up new horizons in the field of liver transplantation and the use of organs from marginal donors after brain death, such as fatty livers and the livers from elderly donors with multiple comorbidities, may be accepted for machine perfusion in Japan in the near future. Expand
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