Machine Perfusion in Liver Transplantation: A Systematic Review and Meta-Analysis

A systematic review and meta-analysis by Jakubauskas et al. aimed to review the literature reporting liver transplant outcomes when using normothermic machine perfusion (NMP) or hypothermic machine perfusion (HMP) for organ preservation compared to static cold storage (SCS). They included 15 studies in the qualitative synthesis (NMP n=6, HMP n=9).  Due to the diversity of the NMP studies, only studies investigative HMP (n=9) were included in the meta-analysis​.

From these studies they found:

  • The potential of NMP to reduce graft injury and lower liver discard rate
  • That HMP reduces
    • Rate of EAD
    • Total biliary complications
    • Non-anastomotic biliary strictures
  • HMP showed a tendency towards improved graft and patient survival at 12-months, though they failed to reach statistical significance

Overall, they concluded that NMP has the potential to reduce graft injury and lower liver graft discard rate. As well as the use of HMP reduces the rate of EAD and non-anastomotic biliary strictures compared to SCS.

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