Machine perfusion of expanded criteria donor livers

12 June 2015  //  Clinical Evidence

In this clinical study, use of hypothermic machine perfusion (HMP) was investigated in donor livers that had initially been rejected by the originating United Network for Organ Sharing (UNOS) region. Investigators reviewed two groups of patients receiving an isolated primary liver transplantation. A total of 31 patients in the intervention arm received HMP livers and 30 patients in the control arm received static cold-stored (SCS) livers that were matched for donor age, recipient age, cold ischemic time, donor risk index and model end-stage liver disease (MELD) score.

Key results

During the 12-month post-transplantation follow-up, compared to SCS, the HMP group showed significantly:

  • Fewer biliary complications (4 vs. 13, respectively; p=0.016)
  • Lower early allograft dysfunction rates (19% vs. 30%)
  • Shorter mean hospital stays (13.6 vs. 20.1 days; p=0.001)

The authors concluded that HMP assists in the safe use of ECD livers, even those rejected by multiple centers. They proposed that this technique will be effective in reducing the incidence of preservation injury in the most susceptible livers, and that its incorporation into clinical practice will help close the gap between organ supply and demand, improving both clinical and economic outcomes of liver transplantation.

Reference

Guarrera JV, et al. Am J Transplant. 2015;15(1):161–169.