Transplantation of discarded livers following viability testing with normothermic machine perfusion.

Mergental, Hynek and Laing, Richard W and Kirkham, Amanda J and Perera, M Thamara P R and Boteon, Yuri L and Attard, Joseph and Barton, Darren and Curbishley, Stuart and Wilkhu, Manpreet and Neil, Desley A H and Hübscher, Stefan G and Muiesan, Paolo and Isaac, John R and Roberts, Keith J and Abradelo, Manuel and Schlegel, Andrea and Ferguson, James and Cilliers, Hentie and Bion, Julian and Adams, David H and Morris, Chris and Friend, Peter J and Yap, Christina and Afford, Simon C and Mirza, Darius F (2020) Transplantation of discarded livers following viability testing with normothermic machine perfusion. Nature communications, 11 (1). p. 2939. ISSN 2041-1723.

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Official URL: https://www.nature.com/articles/s41467-020-16251-3

Abstract

There is a limited access to liver transplantation, however, many organs are discarded based on subjective assessment only. Here we report the VITTAL clinical trial (ClinicalTrials.gov number NCT02740608) outcomes, using normothermic machine perfusion (NMP) to objectively assess livers discarded by all UK centres meeting specific high-risk criteria. Thirty-one livers were enroled and assessed by viability criteria based on the lactate clearance to levels ≤2.5 mmol/L within 4 h. The viability was achieved by 22 (71%) organs, that were transplanted after a median preservation time of 18 h, with 100% 90-day survival. During the median follow up of 542 days, 4 (18%) patients developed biliary strictures requiring re-transplantation. This trial demonstrates that viability testing with NMP is feasible and in this study enabled successful transplantation of 71% of discarded livers, with 100% 90-day patient and graft survival; it does not seem to prevent non-anastomotic biliary strictures in livers donated after circulatory death with prolonged warm ischaemia.

Item Type: Article
Subjects: WI Digestive system. Gastroenterology
WO Surgery
Divisions: Clinical Support > Anaesthetics
Clinical Support > Pathology
Planned IP Care > Gastroentrology
Planned IP Care > General Surgery
Clinical Support > Immunology
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Depositing User: Mrs Yolande Brookes
Date Deposited: 25 Jun 2020 11:39
Last Modified: 25 Jun 2020 11:39
URI: http://www.repository.uhblibrary.co.uk/id/eprint/3204

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