Article
Surgery
Qiang Liu, Luca Del Prete, Khaled Ali, Patrick Grady, Mary Bilancini, John Etterling, Giuseppe D'Amico, Teresa Diago Uso, Koji Hashimoto, Federico Aucejo, Masato Fujiki, Bijan Eghtesad, Kazunari Sasaki, Choon Hyuck David Kwon, Sulemon Chaudhry, Junshi Doi, Alejandro Pita, Brandon New, Ana Bennett, Jacek Cywinski, Charles Miller, Cristiano Quintini
Summary: The purpose of this study was to assess the safety and feasibility of sequential hypothermic oxygenated perfusion and normothermic machine perfusion and the potential benefits of graft viability preservation and assessment before liver transplantation. 17 expanded criteria donor livers underwent sequential hypothermic oxygenated perfusion and normothermic machine perfusion. The results showed that sequential hypothermic oxygenated perfusion and normothermic machine perfusion preservation is safe and feasible and has the potential benefits of preserving and evaluating expanded criteria donor livers.
Article
Surgery
Otto B. van Leeuwen, Silke B. Bodewes, Veerle A. Lantinga, Martijn P. D. Haring, Adam M. Thorne, Isabel M. A. Bruggenwirth, Aad P. van den Berg, Marieke T. de Boer, Iris E. M. de Jong, Ruben H. J. de Kleine, Bianca Lascaris, Maarten W. N. Nijsten, Koen M. E. M. Reyntjens, Vincent E. de Meijer, Robert J. Porte
Summary: Ex situ machine perfusion using sequential DHOPE-NMP for resuscitation and viability assessment of high-risk donor livers results in excellent transplant outcomes, irrespective of the oxygen carrier used.
AMERICAN JOURNAL OF TRANSPLANTATION
(2022)
Review
Medicine, General & Internal
Jeannette Widmer, Janina Eden, Mauricio Flores Carvalho, Philipp Dutkowski, Andrea Schlegel
Summary: The renaissance of dynamic preservation techniques has brought extended criteria donor (ECD) livers back into the transplantable organ pool. However, there is ongoing debate about the advantages and disadvantages of different perfusion strategies and their best applications for specific categories of marginal livers.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Surgery
Ivo J. Schurink, Femke H. C. de Goeij, Lex J. M. Habets, Fenna E. M. van de Leemkolk, Christian A. A. van Dun, Gabriel C. Oniscu, Ian P. J. Alwayn, Wojciech G. Polak, Volkert A. L. Huurman, Jeroen de Jonge
Summary: This study demonstrates that declined liver grafts donated after circulatory death (DCD) can be salvaged with abdominal normothermic regional perfusion (aNRP), avoiding primary nonfunction and reducing the occurrence of ischemic cholangiopathy.
Article
Gastroenterology & Hepatology
Michel Rayar, Jean-Marie Beaurepaire, Emma Bajeux, Stephanie Hamonic, Thomas Renard, Clara Locher, Veronique Desfourneaux, Aude Merdrignac, Damien Bergeat, Mohamed Lakehal, Laurent Sulpice, Pauline Houssel-Debry, Caroline Jezequel, Christophe Camus, Edouard Bardou-Jacquet, Bernard Meunier
Summary: The use of HOPE in liver transplantation can effectively lower AST and ALT levels, reduce ICU and hospital stay, without increasing the incidence of early allograft dysfunction or affecting graft and patient survival rates. The additional cost of HOPE per patient is estimated, but the overall cost and revenue balance does not significantly differ from the control group. These findings need further validation in a randomized trial.
LIVER TRANSPLANTATION
(2021)
Article
Surgery
Zhitao Chen, Xitao Hong, Shanzhou Huang, Tielong Wang, Yihao Ma, Yiwen Guo, Changjun Huang, Qiang Zhao, Zhiyong Guo, Xiaoshun He, Weiqiang Ju, Maogen Chen
Summary: The technique of continuous normothermic machine perfusion without recooling in liver transplantation with extended criteria donor livers was found to be effective and safe in two cases, with no early allograft dysfunction or primary graft non-function observed. Further research is needed to confirm these promising results.
FRONTIERS IN SURGERY
(2021)
Article
Surgery
Cristiano Quintini, Luca Del Prete, Andrea Simioni, Laurent Del Angel, Teresa Diago Uso, Giuseppe D'Amico, Koji Hashimoto, Federico Aucejo, Masato Fujiki, Bijan Eghtesad, Kazunari Sasaki, Choon Hyuck David Kwon, Jacek Cywinski, Ana Bennett, Mary Bilancini, Charles Miller, Qiang Liu
Summary: This study demonstrated the successful transplantation of 71.5% of discarded livers after ex vivo normothermic machine perfusion and assessment using an institutionally built device. The findings challenge the current viability criteria and call for standardization of viability marker collection.
Article
Surgery
William C. Chapman, Andrew S. Barbas, Anthony M. D'Alessandro, Rodrigo Vianna, Chandrashekhar A. Kubal, Peter Abt, Christopher Sonnenday, Rolf Barth, Josue Alvarez-Casas, Hasan Yersiz, Devin Eckhoff, Robert Cannon, Yuri Genyk, Linda Sher, Andrew Singer, Sandy Feng, Garrett Roll, Ari Cohen, Maria B. Doyle, Debra L. Sudan, David Al-Adra, Adeel Khan, Vijay Subramanian, Nader Abraham, Kim Olthoff, Akin Tekin, Lynn Berg, Constantin Coussios, Chris Morris, Lucy Randle, Peter Friend, Stuart J. Knechtle
Summary: This study compared the effects of conventional low-temperature storage and storage at physiological body temperature on liver transplantation. The results showed that normothermic machine perfusion (NMP) did not significantly reduce early posttransplant liver injury and function, but it may have greater benefits for high-risk donor livers.
Article
Surgery
Matteo Mueller, Max Hefti, Dilmurodjon Eshmuminov, Martin J. Schuler, Richard X. Sousa Da Silva, Henrik Petrowsky, Michelle L. De Oliveira, Christian E. Oberkofler, Catherine Hagedorn, Leandro Mancina, Achim Weber, Brian Burg, Mark W. Tibbitt, Philipp Rudolf von Rohr, Philipp Dutkowski, Dustin Becker, Lucia Bautista Borrego, Pierre-Alain Clavien
Summary: This study successfully achieved the long-term machine perfusion of partial human livers, demonstrating stable perfusion and normal hepatic function and architecture, paving the way for innovative clinical applications and approaches in hepatic oncology.
Article
Immunology
Zhitao Chen, Tielong Wang, Chuanbao Chen, Qiang Zhao, Yihao Ma, Yiwen Guo, Xitao Hong, Jia Yu, Changjun Huang, Weiqiang Ju, Maogen Chen, Xiaoshun He
Summary: This study introduces a novel liver transplant technique, continuous normothermic machine perfusion (NMP) without recooling, to avoid a second ischemia-reperfusion injury to the donor liver. Compared to traditional methods, this technique shows potential in reducing liver damage.
Review
Medicine, General & Internal
Fabio Melandro, Riccardo De Carlis, Francesco Torri, Andrea Lauterio, Paolo De Simone, Luciano De Carlis, Davide Ghinolfi
Summary: This review summarizes the current literature on viability criteria during normothermic and hypothermic machine perfusion, and discusses the future steps and evolution of these technologies.
MEDICINA-LITHUANIA
(2022)
Article
Surgery
Zoltan Czigany, Johann Pratschke, Jiri Fronek, Markus Guba, Wenzel Schoening, Dimitri Aristotle Raptis, Joachim Andrassy, Matthijs Kramer, Pavel Strnad, Rene Hany Tolba, Wenjia Liu, Theresa Keller, Hannah Miller, Sandra Pavicevic, Deniz Uluk, Matej Kocik, Isabella Lurje, Christian Trautwein, Arianeb Mehrabi, Irinel Popescu, Florian Wolfgang Rudolf Vondran, Cynthia Ju, Frank Tacke, Ulf Peter Neumann, Georg Lurje
Summary: This study demonstrates that HOPE significantly reduces early allograft injury and improves post-transplant outcomes in ECD-DBD liver transplantation compared to SCS.
Article
Surgery
Peri Husen, Catherine Boffa, Ina Jochmans, Christina Krikke, Lucy Davies, Laura Mazilescu, Aukje Brat, Simon Knight, Daniel Wettstein, Orsolya Cseprekal, Neal Banga, Maria Irene Bellini, Laszlo Szabo, Elijah Ablorsu, Tom Darius, Isabel Quiroga, Michel Mourad, Johann Pratschke, Vassilios Papalois, Zoltan Mathe, Henri G. D. Leuvenink, Thomas Minor, Jacques Pirenne, Rutger J. Ploeg, Andreas Paul
Summary: In this randomized clinical trial, preimplantation short-term reconditioning of kidney grafts using oxygenated hypothermic machine perfusion did not lead to an improvement in 1-year graft survival compared to kidneys that underwent static cold storage alone, suggesting that this approach is not beneficial in kidneys retrieved from expanded criteria donors.
Article
Hematology
Bente P. Van den Boom, Silke B. Bodewes, Bianca Lascaris, Jelle Adelmeijer, Robert J. Porte, Vincent E. de Meijer, Ton Lisman
Summary: Normothermic machine perfusion (NMP) of donor livers allows for new diagnostic and therapeutic strategies. However, high concentrations of heparin and low levels of fibrinogen may affect coagulation assays such as the International Normalised Ratio (INR) performed in perfusate.
THROMBOSIS RESEARCH
(2023)
Article
Multidisciplinary Sciences
Ngee-Soon Lau, Mark Ly, Claude Dennis, Andrew Jacques, Marti Cabanes-Creus, Shamus Toomath, Joanna Huang, Nicole Mestrovic, Paul Yousif, Sumon Chanda, Chuanmin Wang, Leszek Lisowski, Ken Liu, James G. Kench, Geoffrey McCaughan, Michael Crawford, Carlo Pulitano
Summary: Long-term machine perfusion of human livers outside the body is an emerging field with tremendous potential for the assessment, recovery, and modification of organs prior to transplantation. Here, the authors report the long-term ex situ perfusion of human livers and demonstrate the ability to split and perfuse these organs using a standardised protocol.
NATURE COMMUNICATIONS
(2023)
Review
Biochemistry & Molecular Biology
Alessandro Parente, Mauricio Flores Carvalho, Janina Eden, Philipp Dutkowski, Andrea Schlegel
Summary: Tumor recurrence after liver transplantation is linked to multiple factors. Dynamic perfusion strategies, such as machine perfusion and endischemic organ improvement, have shown promising results in reducing complication and recurrence rates.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2022)
Review
Medicine, General & Internal
Jeannette Widmer, Janina Eden, Mauricio Flores Carvalho, Philipp Dutkowski, Andrea Schlegel
Summary: The renaissance of dynamic preservation techniques has brought extended criteria donor (ECD) livers back into the transplantable organ pool. However, there is ongoing debate about the advantages and disadvantages of different perfusion strategies and their best applications for specific categories of marginal livers.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Gastroenterology & Hepatology
Andrea Schlegel, Matteo Mueller, Xavier Mueller, Janina Eden, Rebecca Panconesi, Stefanie von Felten, Klaus Steigmiller, Richard X. Sousa Da Silva, Olivier de Rougemont, Jean-Yves Mabrut, Mickael Lesurtel, Miriam Cortes Cerisuelo, Nigel D. Heaton, Marc Antoine Allard, Rene Adam, Diethard Monbaliu, Ina Jochmans, Martijn P. D. Haring, Robert J. Porte, Alessandro Parente, Paolo Muiesan, Philipp Kron, Magdy Attia, Dagmar Kollmann, Gabriela Berlakovich, Xavier Rogiers, Karin Petterson, Anne L. Kranich, Stefanie Amberg, Beat Mullhaupt, Pierre-Alain Clavien, Philipp Dutkowski
Summary: Hypothermic oxygenated perfusion (HOPE) after cold storage of donated livers reduces the incidence of complications and graft failure in liver transplantation.
JOURNAL OF HEPATOLOGY
(2023)
Letter
Gastroenterology & Hepatology
Marianna Maspero, Koji Hashimoto, Robert L. Fairchild, Andrea Schlegel
Letter
Gastroenterology & Hepatology
Marianna Maspero, Koji Hashimoto, Robert L. Fairchild, Andrea Schlegel
Review
Biochemistry & Molecular Biology
Alessandro Parente, Hwui-Dong Cho, Ki-Hun Kim, Andrea Schlegel
Summary: The aim of this study was to assess the association between graft-to-recipient weight ratio (GRWR) and hepatocellular carcinoma (HCC) recurrence in adult-to-adult living donor liver transplantation (LDLT). Three studies were identified, involving a total of 782 patients. The results showed that GRWR < 0.8% was associated with lower survival rates and higher tumor recurrence rates in HCC recipients, particularly for patients with HCC outside the established criteria. Considering individual GRWR as a contributor to HCC recurrence in LDLT patients may be beneficial.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Review
Biochemistry & Molecular Biology
Alessandro Parente, Mauricio Flores Carvalho, Andrea Schlegel
Summary: The endothelium, forming the inner layer of blood vessels, plays a crucial role in intercellular communication and vascular homeostasis. Recent studies have highlighted the importance of endothelial cells in metabolic function and their response to flow changes, which are linked to mitochondrial health. The impact of different perfusion conditions on liver sinusoidal endothelial cells (LSECs) and their mitochondrial function in the context of liver transplantation is discussed in this article. The available ex situ machine perfusion strategies and their effects on LSEC health are described, with a focus on specific perfusion conditions such as pressure, duration, and oxygenation.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Article
Gastroenterology & Hepatology
Alessandro Parente, Fabio Tirotta, Alessia Pini, Janina Eden, Daniele Dondossola, Tommaso M. Manzia, Philipp Dutkowski, Andrea Schlegel
Summary: Machine perfusion in liver transplantation can reduce the incidence of early allograft dysfunction and major complications. However, more comparative clinical trials and long-term follow-up studies are needed to support its application in clinical practice.
JOURNAL OF HEPATOLOGY
(2023)
Review
Gastroenterology & Hepatology
Andrea Schlegel, Hynek Mergental, Constantino Fondevila, Robert J. Porte, Peter J. Friend, Philipp Dutkowski
Summary: With increasing demand for donor livers, there is a need to expand the number and quality of available organs. Dynamic preservation approaches have shown benefits in improving liver function and reducing complications. However, some livers still do not meet viability tests even with modern perfusion techniques. To optimize machine liver perfusion, extended perfusion with ex situ treatment and the use of stem cells or molecules targeting repair mechanisms are promising options. Bioengineering techniques can also be used to develop optimized organs during machine perfusion. This review discusses current strategies to improve donor liver quality and the challenges and benefits associated with different perfusion strategies.
JOURNAL OF HEPATOLOGY
(2023)
Article
Medicine, General & Internal
Tom Darius, Martial Vergauwen, Louis Maistriaux, Robin Evrard, Andrea Schlegel, Matteo Mueller, Donna O'Neil, Andrew Southam, Selda Aydin, Arnaud Devresse, Martine De Meyer, Pierre Gianello, Christian Ludwig, Philipp Dutkowski, Michel Mourad
Summary: Short bubble and subsequent intermittent surface oxygenation is an effective and cheap preservation strategy during hypothermic machine perfusion (HMP), which can protect mitochondria and eliminate the need/costs of a membrane oxygenator and oxygen source during transport.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Medicine, General & Internal
Alessandro Parente, Mauricio Flores Carvalho, Rebecca Panconesi, Yuri L. Boteon, Riccardo De Carlis, Philipp Dutkowski, Paolo Muiesan, Daniele Dondossola, Andrea Schlegel
Summary: This study investigates the current trends and obstacles to the implementation of dynamic perfusion concepts in liver transplantation on an international scale. A web-based survey was conducted among experts from 70 centers in 34 countries. The results show that while dynamic preservation techniques are increasingly used in clinical practice, financial, knowledge, and personnel challenges remain.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Engineering, Biomedical
Amanda P. C. S. Boteon, Marisa R. D. Lima, Bianca Della Guardia, Mauricio F. Carvalho, Andrea Schlegel, Yuri L. Boteon
Summary: This case report highlights the use of HOPE treatment for an extended criteria donor organ, allowing for successful liver retransplantation in a complex surgical case. Further research is needed, but HOPE may have the potential to expand the donor organ pool and reduce the time constraints of transplantation surgeries.
Article
Engineering, Biomedical
Roberta Angelico, Bruno Sensi, Claudia Quaranta, Michela Orsi, Alessandro Parente, Andrea Schlegel, Giuseppe Tisone, Tommaso M. Manzia
Summary: Machine perfusion (MP) is a technique used to improve liver transplantation (LT) outcomes and expand the donor pool. This study surveyed LT centers worldwide to gather information on the use of MP and compared the results between high-volume and low-/mid-volume centers. Significant disparities were found in logistics, utilization, and outcomes between the two groups.
Review
Gastroenterology & Hepatology
Marianna Maspero, Sumeyye Yilmaz, Beatrice Cazzaniga, Roma Raj, Khaled Ali, Vincenzo Mazzaferro, Andrea Schlegel
Summary: Understanding the mechanisms of perioperative liver injury is crucial in preventing cancer recurrence. This review explores the key mechanisms and potential treatments for perioperative liver injury.
Letter
Surgery
Angus Hann, Syed Soulat Raza, Dimitri Sneiders, Anisa Nutu, Hynek Mergental, Darius F. Mirza, Hermien Hartog, M. Thamara Pr Perera
BRITISH JOURNAL OF SURGERY
(2022)