Evolving Trends in Machine Perfusion for Liver Transplantation

A recent review article by Dutkowski et al. looked at the evolving evidence for machine perfusion in liver transplantation.  They explored the evidence and requirements for both HMP and NMP.

They presented the following information:

  • That endpoints need to be strictly chosen in order to show evidence of clinical benefits 
    •  AST levels poorly reflect outcomes
    • Hospital length of stay is subjective to transplant centers
  • The importance of targeting the rescue of damaged organs while ensuring acceptance or rejection of a graft is not dependent on whether it was randomized to MP vs SCS
  • The mechanisms of both NMP and HMP are very different 
    • Due to the in vivo conditions of NMP, the inflammatory responses are activated thus the requirement of strategies to reduce ROS in the system are required
    • HMP mitigates the inflammatory response

Overall, they concluded that future investigations should explore more clinically relevant end points and search for the potential protective mechanisms and strategies to evaluate effective repair of the organs prior to transplantation.

Read the full article here: https://doi.org/10.1053/j.gastro.2018.12.037

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