Article
Medicine, General & Internal
Rebecca Panconesi, Mauricio Flores Carvalho, Janina Eden, Marilena Fazi, Fariha Ansari, Leandro Mancina, Nadia Navari, Richard Xavier Sousa Da Silva, Daniele Dondossola, Lucia Bautista Borrego, Matthias Pietzke, Adriano Peris, David Meierhofer, Paolo Muiesan, Alexander Galkin, Fabio Marra, Philipp Dutkowski, Andrea Schlegel
Summary: This study investigated the effects of NRP and HOPE on DCD liver transplantation using an animal model. The results showed that HOPE can reduce mitochondrial injury and inflammation, and improve post-transplant survival.
Article
Immunology
Riccardo De Carlis, Andrea Schlegel, Samuele Frassoni, Tiziana Olivieri, Matteo Ravaioli, Stefania Camagni, Damiano Patrono, Domenico Bassi, Duilio Pagano, Stefano Di Sandro, Andrea Lauterio, Vincenzo Bagnardi, Salvatore Gruttadauria, Umberto Cillo, Renato Romagnoli, Michele Colledan, Matteo Cescon, Fabrizio Di Benedetto, Paolo Muiesan, Luciano De Carlis
Summary: This study found that NRP and D-HOPE yield good results in DCD livers with prolonged warm ischemia in Italy, reducing the incidence of kidney injury.
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
Medicine, General & Internal
R. Van Rijn, I. J. Schurink, Y. de Vries, A. P. van den Berg, M. Cortes Cerisuelo, S. Darwish Murad, J. I. Erdmann, N. Gilbo, R. J. de Haas, N. Heaton, B. van Hoek, V. A. L. Huurman, I. Jochmans, O. B. van Leeuwen, V. E. de Meijer, D. Monbaliu, W. G. Polak, J. J. G. Slangen, R. I. Troisi, A. Vanlander, J. de Jonge, R. J. Porte
Summary: This study demonstrated that hypothermic oxygenated machine perfusion can reduce the risk of nonanastomotic biliary strictures following liver transplantation from donors after circulatory death, with lower rates of complications compared to conventional static cold storage.
NEW ENGLAND JOURNAL OF MEDICINE
(2021)
Article
Surgery
Jose Luis Campo-Canaveral de la Cruz, Eduardo Minambres, Elisabeth Coll, Maria Padilla, Gloria Sanchez Antolin, Gloria de la Rosa, Joel Rosado, Francisco Javier Gonzalez Garcia, Silvana Crowley Carrasco, Gabriel Sales Badia, Eva Maria Fieria Costa, Jose Alberto Garcia Salcedo, Victor Mora, Carlos de la Torre, Rafael Badenes, Lander Atutxa Bizkarguenaga, Beatriz Dominguez-Gil
Summary: This study aimed to investigate the outcomes of lung and liver transplantation using NRP in cDCD donors and compare them with transplants using DBD grafts. The results showed that simultaneous transplantation of lungs and livers from cDCD donors using NRP offers similar outcomes to transplants using DBD grafts.
AMERICAN JOURNAL OF TRANSPLANTATION
(2023)
Article
Surgery
Takayuki Yamamoto, Srilakshmi Atthota, Divyansh Agarwal, Kerry Crisalli, Malcolm Macconmara, Tsukasa Nakamura, Richard Teo, Leigh Anne Dageforde, Shoko Kimura, Nahel Elias, Heidi Yeh, Adel Bozorgzadeh, Tatsuo Kawai, James F. Markmann
Summary: This study compares the outcomes of liver allografts preserved using portable normothermic machine perfusion (NMP) and ischemic cold storage (ICS) in liver transplantation procedures. It concludes that NMP can significantly reduce the incidence of early allograft dysfunction, reperfusion syndrome, and ischemic cholangiopathy after donation after circulatory death (DCD) liver transplantation.
Article
Cardiac & Cardiovascular Systems
Niels Moeslund, Imran A. Ertugrul, Michiel A. Hu, Frederik Flyvholm Dalsgaard, Lars Bo Ilkjaer, Pia Ryhammer, Michael Pedersen, Michiel E. Erasmus, Hans Eiskjaer
Summary: In this study, a novel oxygenated hypothermic machine perfusion (HMP) system was compared to static cold storage (SCS) in heart transplantation (HTX). The results showed that hearts preserved with HMP exhibited increased biventricular contractility post-HTX and required less dobutamine for maintaining cardiac output. Additionally, HMP groups had lower levels of myocardial damage. Therefore, DCD HTX can be successfully performed using DPP followed by preservation with HMP.
JOURNAL OF HEART AND LUNG TRANSPLANTATION
(2023)
Article
Surgery
Michal Grat, Marcin Morawski, Andriy Zhylko, Pawel Rykowski, Maciej Krasnodebski, Anya Wyporski, Jan Borkowski, Zbigniew Lewandowski, Konrad Kobryn, Rafal Stankiewicz, Jan Stypulkowski, Waclaw Holowko, Waldemar Patkowski, Magdalena Mielczarek-Puta, Marta Struga, Benedykt Szczepankiewicz, Barbara Gornicka, Marek Krawczyk
Summary: This study suggests that routine use of end-ischemic hypothermic oxygenated machine perfusion (HOPE) in liver transplantations from donors after brain death (DBD) is not justified, as the clinical benefits are limited to high-risk donors.
Review
Biotechnology & Applied Microbiology
Chuanyan Shen, Hongwei Cheng, Tingting Zong, Hongli Zhu
Summary: The gap between the number of liver transplant patients and available donors is a significant issue in the field of transplantation. Limited access to liver transplantation has led to the use of extended criteria donors to address the growing demand. Preservation before transplantation plays a crucial role in determining patient outcomes, and the use of normothermic machine perfusion shows promise in improving graft viability and assessing viability before transplantation. This review provides an overview of normothermic machine perfusion and its application in liver preservation and pre-transplantation, as well as data from current clinical trials.
FRONTIERS IN BIOENGINEERING AND BIOTECHNOLOGY
(2023)
Review
Medicine, General & Internal
Joseph Mugaanyi, Lei Dai, Changjiang Lu, Shuqi Mao, Jing Huang, Caide Lu
Summary: Machine perfusion, particularly HOPE/D-HOPE and NMP, shows promise as alternatives to static cold storage for the preservation of donor livers. These methods improve graft and patient survival rates and reduce the incidence of biliary complications. They have the potential to address the gap between demand and availability of donor livers by enabling the utilization of marginal livers.
JOURNAL OF CLINICAL MEDICINE
(2023)
Review
Medicine, General & Internal
Maxime Foguenne, Serena MacMillan, Philipp Kron, Jay Nath, Arnaud Devresse, Martine De Meyer, Mourad Michel, Sarah Hosgood, Tom Darius
Summary: The use of high-risk renal grafts for transplantation requires the optimization of pretransplant assessment and preservation reconditioning strategies. Active oxygenation plays a central role in dynamic preservation strategies to recondition mitochondria and restore cellular energy. The differences between normothermic and hypothermic machine perfusion, as well as the logistic and economic implications, should be considered for implementation at a local level.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Surgery
Aurelio Seidita, Rosalia Longo, Fabrizio Di Francesco, Alessandro Tropea, Sergio Calamia, Giovanna Panarello, Marco Barbara, Salvatore Gruttadauria
Summary: The use of normothermic machine perfusion (NMP) to test liver viability before transplantation allows for the preventive use of very marginal grafts, increasing the number of transplants in low donation areas without negatively influencing patient outcomes.
UPDATES IN SURGERY
(2022)
Review
Urology & Nephrology
Asel S. Arykbaeva, Dorottya K. de Vries, Jason B. Doppenberg, Marten A. Engelse, Thomas Hankemeier, Amy C. Harms, Leonie G. Wijermars, Alexander F. Schaapherder, Jaap A. Bakker, Rutger J. Ploeg, Ian P. J. Alwayn, Jan H. N. Lindeman
Summary: Normothermic machine perfusion (NMP) is a novel preservation strategy that maintains organs in a metabolically active state, providing superior organ preservation and allowing viability testing before transplantation. However, current perfusion protocols may not fully address the metabolic requirements of marginal donor grafts. Monitoring of metabolic status during NMP is important for optimal outcomes.
KIDNEY INTERNATIONAL
(2021)
Article
Medicine, General & Internal
Andras T. Meszaros, Julia Hofmann, Madita L. Buch, Benno Cardini, Theresia Dunzendorfer-Matt, Florian Nardin, Michael J. Blumer, Margot Fodor, Martin Hermann, Bettina Zelger, Giorgi Otarashvili, Melanie Schartner, Annemarie Weissenbacher, Rupert Oberhuber, Thomas Resch, Jakob Troppmair, Dietmar Oefner, Heinz Zoller, Herbert Tilg, Erich Gnaiger, Theresa Hautz, Stefan Schneeberger
Summary: Detailed analysis of mitochondrial function and tissue damage can predict the clinical outcome of liver transplantation.
Article
Immunology
Heather Jennings, Kristin N. N. Carlson, Chris Little, Joshua C. C. Verhagen, Jeevan Nagendran, Yongjun Liu, Bret Verhoven, Weifeng Zeng, Stacey McMorrow, Peter Chlebeck, David P. P. Al-Adra
Summary: The choice of oxygen carrier in normothermic ex vivo liver perfusion (NEVLP) can affect the phenotype and function of liver-resident immune cells, with human pRBC showing stronger activation and Oxyglobin having a less pronounced impact on immune cell activation.
FRONTIERS IN IMMUNOLOGY
(2022)
Article
Immunology
Enrique Montagud-Marrahi, Alicia Molina-Andujar, Adriana Pane, Sabina Ruiz, Antonio J. Amor, Enric Esmatjes, Joana Ferrer, Elisenda Banon-Maneus, Evelyn Hermida, Mireia Musquera, Constantino Fondevila, Fritz Diekmann, Pedro Ventura-Aguiar
Summary: This study investigated whether simultaneous pancreas-kidney transplantation (SPKT) can reduce the risk of cardiovascular disease in patients with type 1 diabetes. The results showed that SPKT significantly decreased the predicted cardiovascular risk by the STENO T1. Additionally, the success of pancreas transplantation was found to be unrelated to the incidence of cardiovascular events.
Article
Engineering, Biomedical
Damiano Patrono, Davide Cussa, Federica Rigo, Renato Romagnoli
Summary: This survey reveals significant heterogeneity in indications, techniques, and timing of machine perfusion (MP) in liver transplantation among experts, highlighting the importance of identifying optimal scenarios for each technique. Additionally, viability assessment is emphasized as a fundamental need for transplant professionals when considering the use of MP.
Article
Gastroenterology & Hepatology
Esther Fernandez-Galan, Celia Badenas, Constantino Fondevila, Wladimiro Jimenez, Miquel Navasa, Joan Anton Puig-Butille, Merce Brunet
Summary: This study evaluated the feasibility of using ddcfDNA as a biomarker for predicting acute rejection in liver transplant patients and found that the ddcfDNA percentage was 3-fold higher before AR diagnosis compared to nonrejector patients, showing a better predictive performance than conventional liver function tests within the first 2 weeks post-transplant.
LIVER TRANSPLANTATION
(2022)
Review
Engineering, Biomedical
Yuri L. Boteon, Amelia J. Hessheimer, Isabel M. A. Bruggenwirth, Amanda P. C. S. Boteon, Maria Padilla, Vincent E. de Meijer, Beatriz Dominguez-Gil, Robert J. Porte, M. Thamara P. R. Perera, Paulo N. Martins
Summary: Several clinical studies have demonstrated the safety, feasibility, and efficacy of machine perfusion in liver transplantation, but its economic outcomes are still underexplored. The upfront cost of machine perfusion may vary between modalities, but its use is likely to be cost-effective. Optimization of donor liver utilization rate, decreased complications, changes in logistics, and shorter hospital stays are potential cost savings points highlighted in the limited literature available.
Article
Gastroenterology & Hepatology
Ellen G. Driever, Fien A. von Meijenfeldt, Jelle Adelmeijer, Robbert J. de Haas, Marius C. van den Heuvel, Chandrasekaran Nagasami, John W. Weisel, Constantino Fondevila, Robert J. Porte, Anabel Blasi, Nigel Heaton, Stephen Gregory, Pauline Kane, William Bernal, Yoh Zen, Ton Lisman
Summary: The study found that portal vein thrombosis in cirrhotic patients is mainly composed of intimal fibrosis, with fibrin-rich thrombus present in only one-third of cases. Clinical characteristics showed no significant association with the presence of fibrin-rich thrombi.
Article
Gastroenterology & Hepatology
Andrea Schlegel, Marjolein van Reeven, Kristopher Croome, Alessandro Parente, Annalisa Dolcet, Jeannette Widmer, Nicolas Meurisse, Riccardo De Carlis, Amelia Hessheimer, Ina Jochmans, Matteo Mueller, Otto B. van Leeuwen, Amit Nair, Koji Tomiyama, Ahmed Sherif, Mohamed Elsharif, Philipp Kron, Danny van der Helm, Daniel Borja-Cacho, Humberto Bohorquez, Desislava Germanova, Daniele Dondossola, Tiziana Olivieri, Stefania Camagni, Andre Gorgen, Damiano Patrono, Matteo Cescon, Sarah Croome, Rebecca Panconesi, Mauricio Flores Carvalho, Matteo Ravaioli, Juan Carlos Caicedo, George Loss, Valerio Lucidi, Gonzalo Sapisochin, Renato Romagnoli, Wayel Jassem, Michele Colledan, Luciano De Carlis, Giorgio Rossi, Fabrizio Di Benedetto, Charles M. Miller, Bart van Hoek, Magdy Attia, Peter Lodge, Roberto Hernandez-Alejandro, Olivier Detry, Cristiano Quintini, Gabriel C. Oniscu, Constantino Fondevila, Massimo Malago, Jacques Pirenne, Jan N. M. IJzermans, Robert J. Porte, Philipp Dutkowski, C. Burcin Taner, Nigel Heaton, Pierre-Alain Clavien, Wojciech G. Polak, Paolo Muiesan
Summary: The study established the best possible outcomes and reference values for liver transplantation using grafts donated after circulatory death (DCD) through benchmarking. The benchmark cases showed excellent 1-year retransplant and mortality rates, but had high rates of major complications. The use of organ perfusion technology reduced complications and improved outcomes in high-risk patients.
JOURNAL OF HEPATOLOGY
(2022)
Article
Immunology
Rui Teixeira Da Silva, Raquel G. Bardallo, Emma Folch-Puy, Teresa Carbonell, Carlos M. Palmeira, Constantino Fondevila, Rene Adam, Joan Rosello-Catafau, Arnau Panisello-Rosello
Summary: Hypothermic static cold storage and machine perfusion are current clinical standards for liver graft preservation. Preservation of mitochondrial function and energy levels has emerged as a key aspect, but the relationship between liver mitochondrial protection and perfusate/solution use needs further investigation. The use of alternative solutions like IGL-2 shows promise in maintaining mitochondrial integrity and simplifying logistics, with potential for better transplantation outcomes.
TRANSPLANTATION PROCEEDINGS
(2022)
Article
Gastroenterology & Hepatology
Christopher B. Nahm, Irinel Popescu, Florin Botea, Stephen Fenwick, Constantine Fondevila, Itxarone Bilbao, Daniel Reim, Giles J. Toogood
Summary: This study confirms the safety, efficacy, and ease of use of PuraStat (R) in the management of bleeding in liver surgery.
Review
Gastroenterology & Hepatology
Ivo J. Schurink, Fenna E. M. van de Leemkolk, Constantino Fondevila, Riccardo De Carlis, Eric Savier, Gabriel C. Oniscu, Volkert A. L. Huurman, Jeroen de Jonge
Summary: This review evaluates current protocols for liver viability assessment and finds that the main criteria used for acceptance or decline of transplantation are macroscopic aspect and transaminase levels. Tailored acceptance criteria based on donor type are needed to improve the success rate of transplants.
LIVER TRANSPLANTATION
(2022)
Article
Economics
Jeremy Fabes, Tuba Saygin Avsar, Jonathan Spiro, Thomas Fernandez, Helge Eilers, Steve Evans, Amelia Hessheimer, Paula Lorgelly, Michael Spiro
Summary: This study explores the cost awareness of clinicians across different settings and finds that clinicians often overestimate the cost of common tests while underestimating high-cost tests. The study highlights the need for more training in cost awareness among clinicians.
APPLIED HEALTH ECONOMICS AND HEALTH POLICY
(2022)
Review
Medicine, General & Internal
Antoni Riera-Mestre, Pau Cerda, Yoelimar Carolina Guzman, Adriana Iriarte, Alba Torroella, Jose Maria Mora-Lujan, Jose Castellote, Amelia Hessheimer, Constantino Fondevila, Laura Llado
Summary: This study describes three patients with hemorrhagic hereditary telangiectasia (HHT) requiring liver transplantation (LT) and conducts a systematic review on surgical complications and long-term follow-up. The study demonstrates that pre-assessment of hepatic artery anatomy and circulatory state could reduce complications during LT, and there is a high risk of HHT relapse in the hepatic graft.
JOURNAL OF CLINICAL MEDICINE
(2022)
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
Cell Biology
Alazne Moreno-Lanceta, Mireia Medrano-Bosch, Yilliam Fundora, Meritxell Perramon, Jessica Aspas, Marina Parra-Robert, Sheila Baena, Constantino Fondevila, Elazer R. Edelman, Wladimiro Jimenez, Pedro Melgar-Lesmes
Summary: Hepatic inflammation is a common trigger of chronic liver disease, and macrophage activation is a predictive parameter for survival in patients with cirrhosis. This study investigates the involvement of macrophage RNF41 in liver cirrhosis, revealing its down-regulation and the therapeutic effect of its restoration in fibrotic mice.
SCIENCE TRANSLATIONAL MEDICINE
(2023)
